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Bill

S 4533

Establishes fee on certain employers that employ individuals who receive health benefits coverage through State Medicaid program.

2026-2027 Regular Session Introduced by Joe Vitale

The bill imposes a per-employee and per-dependent annual fee on employers with 50+ workers to help fund Medicaid costs.

Substituted by A5324 (1R)
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Bill Summary · S 4533

Summary of Bill S 4533 (Session 222) – New Jersey

Main purpose and intent

S 4533 would create an annual fee on certain employers to help defray State Medicaid costs. The fee is assessed for each employee and each dependent of that employee who receives health benefits coverage through New Jersey’s State Medicaid program. The measure is designed to shift a portion of Medicaid costs associated with employer-provided coverage onto the employers themselves.

Key provisions and changes

  • Definitions and scope

    • Establishes key terms (Employer, Employee, Dependent, Department, Division, Commissioner) and clarifies who counts as an employer (including corporations, partnerships, LLCs, trusts, etc.) with control over workers in New Jersey.
    • An employer is liable if, in the previous calendar year, it employed 50 or more employees who receive Medicaid health benefits.

  • Fee structure (subsection c)

    • Fees are assessed per affected employee and per dependent who receives Medicaid benefits.
    • Tiered annual fees (based on the number of employees who receive Medicaid among the employer’s workforce):
    • 50–<250 employees: $325 per employee and per dependent
    • 250–<500 employees: $525 per employee and per dependent
    • 500+ employees: $725 per employee and per dependent

  • Exemptions for certain cases (subsection d)

    • Employers do not owe the fee for employees or dependents who have developmental disabilities, intellectual disabilities, or permanent physical disabilities, as defined by state law.

  • Notice, filing, and payment (subsection e)

    • The Division must notify employers by March 1 each year of liability and required filings.
    • Payments and filings are due by April 15 and must be made through electronic methods specified by the Division.

  • ** Penalties (subsection f)**

    • Failure to pay the fee can result in penalties up to $500 per day.

  • Appeals (subsection g)

    • Employers can contest the fee through an administrative appeal, with the Department able to reverse the division’s determination if incorrect.
    • Fees must be paid during the appeal process, and refunds are possible if the Department finds the assessment improper.
    • Appeals follow the Administrative Procedure Act; decisions can be appealed to the Appellate Division.

  • Compliance and audits (subsection h)

    • The Commissioner may audit employer records to ensure proper classification and calculation of the fee.

  • Exclusions effective July 1, 2027 (subsection j)

    • Beginning July 1, 2027, several categories would be excluded from liability:
    • Employees employed for less than 90 days at the time of the fee determination
    • Part-time, per diem, temporary, or seasonal employees
    • If an excluded employee was charged a fee before July 1, 2027, the employer may receive a credit or refund for that employee.

  • Interagency data sharing and regulatory authority (sections 2–3)

    • Requires memoranda of understanding among the Department of Human Services, the Department of Labor and Workforce Development, and the Treasury to share data.
    • Allows the State Treasurer, in consultation with relevant commissioners, to adopt interim regulations to implement the act, with a 365-day effective window for such regulations.

  • Effective date

    • The act takes effect immediately but remains inoperative until July 1, 2026.

Affected parties

  • Employers with 50 or more employees who (in the prior year) have employees or dependents enrolled in State Medicaid health benefits.
  • Employees and dependents receiving Medicaid benefits through the state program.
  • State agencies (Labor, Human Services, Treasury) for administration, data sharing, and enforcement.

Procedural and timeline notes

  • Mandatory annual notification by March 1; payments due by April 15.
  • Beginning July 1, 2027, certain categories of employees become exempt from the fee.
  • Potential regulatory framework to be issued within 365 days of filing, with broader regulation to follow under the Administrative Procedure Act.

Fiscal impact (as noted in the bill’s statement)

  • The proposal aims to raise approximately $145 million in annual revenue for Medicaid cost defrayment.
  • Average annual cost per Medicaid-covered person is estimated at about $1,700, according to the Treasury, though the exact spend per affected employee remains a function of the fee schedule and workforce composition.

Compiled from official sources — confirm details with the bill’s official record.

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