NJ Department of Banking and Insurance Issues Guidance on Coverage of Childhood Immunizations

In a bulletin issued Dec. 5, 2025, the New Jersey Department of Banking and Insurance issued guidance to insurance carriers on health insurance coverage for childhood immunizations.

The Department advises that, regardless of federal actions relating to the childhood immunization schedule, it expects carriers to provide coverage for childhood immunizations recommended by the New Jersey Department of Health, including for the hepatitis B vaccination series, in accordance with State law and without cost sharing or the imposition of additional barriers.

The Department is providing this clarification in response to today’s votes by the Advisory Committee on Immunization Practices in the federal Centers for Disease Control and Prevention (CDC) to revise the federal childhood immunization schedule related to hepatitis B, and with the expectation that additional CDC actions related to other childhood immunizations are likely to follow the vote.

The New Jersey Department of Health issued an Executive Directive recommending that medical providers in the State follow the immunization schedules for the administration of the hepatitis B vaccine for their newborn and infant patients as established by the American Academy of Pediatrics.

“While the federal government is taking actions that threaten the health of residents, New Jersey is reaffirming its commitment to ensuring access to childhood immunizations that safeguard children’s health and well-being,” said Commissioner Justin Zimmerman. “The Department expects carriers to continue to cover childhood immunizations without cost sharing and without any additional barriers.”

As outlined in the bulletin, carriers may not apply cost-sharing or impose additional administrative or utilization management requirements that impede access to childhood immunizations recommended by the New Jersey Department of Health, such as prior authorization policies.

When carriers are acting as administrators for non-state-regulated plans, the Department expects carriers to encourage plan sponsors to take steps that are consistent with the bulletin. Plan sponsors should be made aware of the New Jersey Department of Health guidelines, and carriers should encourage plan sponsors to follow the provisions of the bulletin for coverage provided in New Jersey.