New Jersey A 5019: Prohibits DEP from requiring person under 16 years of age to obtain horseback riding permit to ride in State wildlife management areas.

Bill Text

A5019 

ASSEMBLY, No. 5019 

STATE OF NEW JERSEY

222nd LEGISLATURE

� 

INTRODUCED MAY 7, 2026

Sponsored by:

Assemblywoman� LUANNE M. PETERPAUL

District 11 (Monmouth)

SYNOPSIS

���� Requires pharmacy benefits manager compensation to be 
based on bona fide service fee. 

CURRENT VERSION OF TEXT 

���� As introduced.

�� 

An Act concerning pharmacy benefits manager 
compensation and amending P.L.2023, c.107.

���� Be It 
Enacted by the Senate and General Assembly of 
the State of New Jersey:

���� 1.��� Section 9 of P.L.2023, 
c.107 (C.17B:27F-3.4) is amended to read as follows:

���� 9. a. If a carrier uses a 
pharmacy benefits manager to administer or manage the prescription drug 
benefits of covered persons, any pharmacy benefits manager compensation, for 
purposes of calculating a carrier's anticipated loss ratio or any loss ratio calculated 
as part of any applicable medical loss ratio filing or rate filing, shall: 

���� (1) constitute an 
administrative cost incurred by the carrier in connection with a health 
benefits plan; and

���� (2) not constitute a benefit 
provided under a health benefits plan.� A carrier shall claim only the amounts 
paid by the pharmacy benefits manager to a pharmacy or pharmacist as an 
incurred claim.

���� b.��� Any rate filing 
submitted by a carrier with respect to a health benefits plan that provides 
coverage for prescription drugs or pharmacy services and that is administered 
or managed by a pharmacy benefits manager shall include:

���� (1) a memorandum prepared by a 
qualified actuary describing the calculation of the pharmacy benefits manager 
compensation; and

���� (2) any records and supporting 
information as the department reasonably determines is necessary to confirm the 
calculation of the pharmacy benefits manager compensation.

���� c.���� Upon request, a carrier 
shall provide any records to the department that relate to the calculation of 
the pharmacy benefits manager and pharmacy services administrative organization 
compensation.

���� d.��� A pharmacy benefits 
manager and pharmacy services administrative organization shall provide any 
necessary documentation requested by a carrier that relates to pharmacy 
benefits manager compensation in order to comply with the requirements of this 
section.

���� e.���� (1) Compensation to 
a pharmacy benefits manager or affiliate of a pharmacy benefits manager for the 
administration and management of prescription drug benefits shall not be in any 
form of a commission structure or fee other than a bona fide service fee. 

���� (2)�� As used in this 
subsection, �bona fide service fee" means a fee 
that is reflective of the fair market value, as determined by the Commissioner 
of Banking and Insurance, for a bona fide, itemized service actually performed 
on behalf of a purchaser, that the purchaser would otherwise perform or 
contract for in the absence of a pharmacy benefits management services contract 
and that is not passed on in whole or in part to a covered person. �The fee shall 
be in a flat dollar amount and shall not be directly or indirectly based on, or 
contingent upon:

���� (a)�� a drug price, such as 
wholesale acquisition cost, or a drug benchmark price, such as average 
wholesale price; 

���� (b)�� the amount of 
discounts, rebates, fees, or other direct or indirect remuneration with respect 
to a drug dispensed to a covered person; 

���� (c)�� formulary placement 
decisions or the volume or value of any referrals or business generated between 
the pharmacy benefits manager and purchaser; or 

���� (d)�� any other amounts or 
methodologies prohibited by the department.

(cf: P.L.2023, c.107, s.9)

���� 2.��� This act shall take 
effect on the first day of the fourth month next following the date of 
enactment and shall apply to contracts and agreements entered into, renewed, 
modified, or amended on or after the effective date, but the Commissioner of 
Banking and Insurance may take such anticipatory administrative action in 
advance thereof as shall be necessary for the implementation of this act.

STATEMENT

���� This bill establishes pharmacy 
benefits manager compensation based on a bona fide service fee.

���� Under the bill, compensation 
to a pharmacy benefits manager or affiliate of a pharmacy benefits manager for 
the administration and management of prescription drug benefits may not be in 
any form of a commission structure or fee other than a bona fide service fee.� 
For purposes of this bill, �bona fide service fee" means a fee that is 
reflective of the fair market value, as determined by the Commissioner of 
Banking and Insurance, for a bona fide, itemized service actually performed on 
behalf of a purchaser, that the purchaser would otherwise perform or contract 
for in the absence of a pharmacy benefits management services contract and that 
is not passed on in whole or in part to a covered person.� The fee is required 
to be a flat dollar amount and may not be direc