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Bill

S 4415

Strengthens oversight and enforcement of network adequacy requirements for health insurance carriers; requires health insurance carriers to make network directory available.*

2026-2027 Regular Session Introduced by Angela McKnight and 2 co-sponsors

DOBI will annually evaluate minors’ mental health coverage and require carriers to keep up-to-date provider directories to improve access and transparency.

Referred to Senate Budget and Appropriations Committee
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Bill Summary · S 4415

Bill Summary: S 4415 (New Jersey, 222nd Session)

Purpose and intent

S 4415 requires the Department of Banking and Insurance (DOBI) to actively monitor and evaluate mental health insurance coverage for minors and to submit an annual report detailing findings and recommendations. The bill also mandates health insurance carriers to maintain and regularly update provider directories. The overarching aim is to improve access to mental health services for children and adolescents and increase transparency and accountability in coverage and provider availability.

Key provisions

  • DOBI monitoring, evaluation, and annual reporting

    • DOBI must monitor mental health insurance coverage for minors across health plans.
    • The department is responsible for evaluating access, adequacy, and effectiveness of coverage for mental health services for individuals under 18.
    • An annual report must be submitted, outlining:
    • The extent of coverage (including services covered and any limitations or barriers).
    • The accessibility of in-network providers for mental health care.
    • Gaps, trends, and potential disparities in access to care.
    • Recommendations for policy or regulatory adjustments to improve coverage and access.

  • Provider directory requirements for carriers

    • Health insurance carriers are required to maintain up-to-date provider directories.
    • Directories must include current information on mental health professionals who accept provided plans, location, contact information, and whether they are accepting new patients.
    • Carriers may be subject to periodic verification and updates to ensure accuracy.
    • The intent is to reduce confusion and delays for families seeking mental health services for minors by ensuring reliable provider information.

Who is affected

  • Individuals under 18: Beneficiaries of health insurance who seek mental health services will be indirectly affected through improved coverage evaluations and potentially better access to in-network providers.
  • Families and caretakers: May experience reduced barriers to finding appropriate mental health care for minors due to more transparent provider directories and enhanced coverage oversight.
  • Insurance carriers and plans: Must comply with provider directory maintenance requirements and cooperate with DOBI’s monitoring and reporting processes.
  • DOBI (Department of Banking and Insurance): Assigned expanded duties to systematically monitor, evaluate, and report on pediatric mental health coverage and access.

Procedural and timeline aspects

  • Annual reporting cycle: DOBI must produce and publish an annual report on the state of minors’ mental health coverage, with data collection and analysis presumably aligned to a calendar or fiscal year as determined by the department.
  • Compliance and updates: Carriers are required to maintain up-to-date provider directories, with ongoing duties to verify and refresh information to ensure accuracy.
  • Implementation considerations: The bill may entail rulemaking or guidance from DOBI to define metrics for evaluation (e.g., service types covered, wait times, in-network access) and to outline the format and frequency of required reporting.

Potential impact and considerations

  • Improved transparency: Families gain clearer information on what mental health services are covered for minors and how to find in-network providers.
  • Access to care: Regular evaluation and reporting could help identify gaps or bottlenecks in coverage, prompting policy adjustments or carrier network improvements.
  • Administrative burden: Carriers will incur ongoing costs to maintain accurate provider directories and to support DOBI’s monitoring and annual reporting.
  • Data-driven policy: The annual report can inform legislative and regulatory decisions aimed at expanding access to pediatric mental health services.

Note: This summary reflects the bill’s stated provisions. For exact statutory language, implementation timelines, and any amendments, consult the official bill text and legislative analyses.

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

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