Requires DOBI to monitor, evaluate, and submit annual report concerning mental health insurance coverage for minors; requires carriers to maintain provider directory.

2026-2027 Regular Session Introduced by Linda Carter and 3 co-sponsors

DOBI will monitor and report annually on how private insurers cover mental health services for minors, to improve coverage and access.

Introduced, Referred to Assembly Financial Institutions and Insurance Committee

Summary of Bill A 5237 (Session 222, New Jersey)

Purpose and intent

A 5237 would require the Department of Banking and Insurance (DOBI) to actively monitor and evaluate mental health insurance coverage for minors and to submit an annual report on this issue. The bill also requires health insurance carriers to maintain up-to-date provider directories. The sponsors are Co-sponsors Linda Carter, Andrea Katz, and Jim Kennedy.

Key provisions

DOBI monitoring, evaluation, and annual reporting on minors’ mental health coverage

DOBI would be responsible for continuously monitoring how private health insurers cover mental health services for individuals under 18.
The department would evaluate the adequacy, accessibility, and quality of mental health benefit coverage for minors.
An annual report would be submitted detailing findings, trends, gaps, and potential recommendations to improve coverage and access.

Provider directory requirements for carriers

Health insurance carriers would be required to maintain current and accessible provider directories.
The directories should identify providers who offer mental health services and be updated to reflect changes in networks, specialties, and contact information.
The intent is to facilitate easier access for families seeking mental health care for minors by ensuring families can locate participating providers.

Affected entities

Department of Banking and Insurance (DOBI)

Responsible for implementing monitoring, evaluation, and annual reporting.

Private health insurance carriers/regulatory subject entities

Required to maintain accurate, up-to-date provider directories, including mental health service providers.

Minors and their families

Directly impacted by improved oversight of mental health coverage and easier access to in-network providers.

Procedural and timeline aspects

The bill would establish ongoing duties for DOBI to monitor and evaluate coverage and to publish an annual report. Specific reporting timelines (e.g., each calendar or state fiscal year) are not detailed in the summary, but the annual report requirement implies a yearly publication cycle.

The provider directory requirement would be phased in according to the bill’s text (not fully detailed here); carriers must maintain directories consistent with the new mandate.

Potential impact

Access and transparency: Families could experience improved access to mental health care for minors due to enhanced oversight and more reliable, current provider directories.

Accountability: DOBI’s annual reports would create formal accountability for insurers regarding pediatric mental health coverage.

Administrative burden: Carriers may incur additional administrative work to maintain current directory information and to align benefits with any evolving standards or findings from the annual DOBI reports.

Notes

The bill has three co-sponsors: Linda Carter, Andrea Katz, and Jim Kennedy, indicating cross-party or varied support in the New Jersey Legislature.

The summary reflects commonly expected components of such a bill; the exact methodology for evaluation, report contents, and any enforcement mechanisms would be found in the bill’s full text and any implementing regulations.