S.963

Health Insurance Claim Plain Language and Simplification Act requires carriers to provide clear, simple explanation of benefits forms to insured.

The Health Insurance Claim Plain Language and Simplification Act mandates that health insurance carriers in New Jersey provide written explanation of benefits forms to insured individuals when a claim is generated. These forms must include specific information in a clear, simple, and plain language format, consistent with the Life and Health Insurance Policy Language Simplification Act. The required information includes the name of the insured, the health care provider, the date of service, the amount of the claim, the amount paid by the carrier, and the amount to be paid by the insured.