Environment
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
StateNew JerseyReported
A 5046: Requires health care claims experience data to be shared with local governments.
Mike Venezia
A 5046 status: Reported — Reported and Referred to Assembly Appropriations Committee (updated Sep 17, 2026).
Source
LegiScan
Confidence
High
Analysis basis
LegiScan full bill text
01
What this bill does
Official summary alongside an AI-generated read on where it stands and why.
Overall Score
77OUT OF 100
Score:77/100 civic fit
Risk:Moderate Risk
Impact:Moderate Impact 60/100
Constitutionality95%
Bipartisan75%
Public opinion80%
Bill summary
What changes
Requires health insurers, TPAs, and Pharmacy Benefit Managers (PBMs) to provide complete claims experience data (including loss reports, rebates, and spread pricing) to local government employers upon request.
Who is affected
Local units (municipalities, counties, school boards, fire districts), health insurance carriers, third-party administrators, and pharmacy benefits managers.
Requirements and enforcement
Entities must provide the requested electronic and manual data within 60 days of a written request at no cost to the local unit, while adhering to HIPAA privacy standards.
Costs and funding
Insurers and PBMs may incur administrative costs for data aggregation and reporting; local units may face costs in analyzing technical data.
When it takes effect
Takes effect on the 180th day following the date of enactment.
Potential benefits
Increases transparency for taxpayers, enhances budget control for local governments, and forces disclosure of PBM rebate practices.
Risks and tradeoffs
Potential for privacy risks, administrative burdens on health vendors, and the complexity of managing large volumes of claims data.
What is still unknown
The extent to which private vendors might contest the scope of 'complete' data or the definitions of proprietary rebates/spread pricing.
02
Impact analysis
✦ AI analysisModeled effects across six domains, estimated from bill text and comparable legislation.
Economy
Positive outlook
75%
Benefits
- Enhanced ability for local governments to analyze benefit costs
- Improved leverage for local units during contract negotiations
- Increased transparency in pharmacy benefit manager (PBM) pricing
Risks
- Compliance and administrative costs for health care carriers
- Implementation burden for pharmacy benefits managers
- Potential for cost-shifting to employers to cover compliance efforts
Society
Positive outlook
70%
Benefits
- Greater stability for public employee health benefit programs
- Improved fiscal management of local government budgets
- Enhanced accountability to taxpayers regarding public funds
Risks
- Risk of accidental disclosure of sensitive employee information
- Increased administrative complexity in maintaining benefit plan records
- Potential confusion from misinterpreting complex actuarial claims data
Technology Industry
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
Civic Accountability
Positive outlook
85%
Benefits
- Establishes a mandatory right to information for public employers
- Grants oversight authority to the Department of Banking and Insurance
- Provides clear enforcement mechanisms for non-compliant vendors
Risks
- Potential for legal disputes regarding definitions of 'complete' data
- Burden on state oversight to investigate and enforce data requests
- Administrative friction when dealing with multi-jurisdictional carriers
Public Health & Safety
No direct effect
Neutral — no direct effect identified.
Benefits
- No material direct effect identified.
Risks
- No material direct effect identified.
03
How trustworthy & consequential it is
Sourcing already shown above, this is what the analysis found worth flagging.
Source
LegiScan
Official bill text or data from LegiScan.
Confidence
High
Information is complete and verified.
Analysis basis
LegiScan full bill text
Source used for this bill's analysis.
Source note
Compliance with HIPAA is required, but the transmission of large-scale claims data increases the attack surface for potential sensitive data breaches.
Analysis scope
Does not specify the technical security protocols for data transfer beyond federal HIPAA requirements.
04
Where it stands
Official record- IntroducedComplete
- CommitteeCurrent
- Chamber votesUpcoming
- Final agreementUpcoming
- GovernorUpcoming
- EnactedUpcoming
05
How it affects your district
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06
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