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A 5341

Relates to the restriction on certain facilities being located within a certain distance from cannabis storefronts

2025 Regular Session Introduced by Anil Beephan and 49 co-sponsors

Requires New Jersey health plans to cover Alzheimer’s and related dementia screening for insureds 65+, to the same extent as any other condition.

REFERRED TO RULES
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WeVote Research Nonpartisan
Bill Summary · A 5341

Summary — A5341 (Introduced Feb 20, 2025)

Overview / Purpose

A5341 requires New Jersey-regulated health insurance plans and contracts to cover screening for Alzheimer’s disease and related disorders for covered persons age 65 or older. The coverage mandate applies across a broad set of private plan types regulated by the Commissioner of Banking and Insurance.

Note: the bill text provided addresses Alzheimer’s screening; a different short title referencing cannabis storefront distance restrictions appears inconsistent with the bill body.

Key provisions

  • Requires coverage for screening for “Alzheimer’s disease and related disorders” for covered persons who are 65 years of age or older.
  • The coverage requirement applies to the following plan and contract types when delivered, issued, executed, or renewed in New Jersey on or after the act’s effective date:
    • Hospital service corporation contracts (P.L.1938, c.366)
    • Medical service corporation contracts (P.L.1940, c.74)
    • Health service corporation contracts (P.L.1985, c.236)
    • Individual health insurance policies (N.J.S.17B:26-1 et seq.)
    • Group health insurance policies (N.J.S.17B:27-26 et seq.)
    • Individual health benefits plans (P.L.1992, c.161)
    • Small employer health benefits plans (P.L.1992, c.162)
    • Health maintenance organization (HMO) contracts (P.L.1973, c.337)
  • For each covered plan type, benefits for Alzheimer’s screening must be provided “to the same extent as for any other condition” under the policy or contract.
  • Applicability language: each section specifies it applies to contracts/policies in which the carrier, corporation, or HMO has reserved the right to change the premium or schedule of charges.
  • Definition: “Alzheimer’s disease and related disorders” is defined as forms of dementia with a general loss of intellectual abilities severe enough to interfere with social or occupational functioning.

Who is affected

  • Insurers, health service/medical/hospital service corporations, health benefits carriers, and HMOs regulated in New Jersey.
  • Covered persons aged 65 and older who hold (or are covered under) the specified plans and policies issued, delivered, or renewed on or after the act’s effective date.
  • Health care providers who perform screening services for Alzheimer’s/dementia (may see increased screening claims).

Implementation / Timeline

  • Coverage becomes required for applicable contracts and policies delivered, issued, executed, or renewed in the State on or after the statute’s effective date (the bill text does not specify an explicit calendar effective date).
  • The bill repeatedly indicates applicability only to contracts where the carrier has reserved the right to change premiums (or HMOs have reserved right to change schedule of charges).

Potential impacts and considerations

  • Likely to increase utilization of cognitive/dementia screening among people 65+ insured under affected plans, potentially supporting earlier detection and referral for care.
  • Insurers will incur additional screening-related costs; the bill does not specify reimbursement rates, frequency limits, or which screening tools/tests are covered.
  • Because benefits must be provided “to the same extent as for any other condition,” insurers may apply existing cost-sharing, utilization management, or prior authorization rules consistent with other covered services.
  • The bill does not address public programs (e.g., Medicaid, Medicare) or specify coverage of diagnostic follow-up after positive screens.

Legislative status & sponsors

  • Introduced: Feb 20, 2025 (referred initially to Assembly Financial Institutions and Insurance Committee).
  • Actions (selected): Reported, printed as A5341A; Passed Assembly (June 6, 2025); delivered to Senate and referred to Senate Rules Committee.
  • Primary sponsors: Assemblymembers Linda S. Carter, Verlina Reynolds-Jackson, and Robert J. Karabinchak. Numerous cosponsors from both parties are listed.
  • Companion Senate bills: S4323 and S7275.

Notes / Observations

  • The bill text does not define which specific screening modalities or clinical criteria constitute covered “screening for Alzheimer’s disease and related disorders,” leaving implementation details to regulation or insurer policy.
  • The coverage trigger applies to plans/contracts issued, delivered, or renewed on or after the act’s effective date; absent an explicit effective date in the text, timing will depend on the enacted law’s provisions.
  • The header/title provided with the user’s materials references cannabis storefront distance restrictions, which appears unrelated to the bill text; the substantive analysis above reflects the bill language concerning Alzheimer’s screening.

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

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