NJ Law Requires Medical Coverage; Six-Week ACA Open Enrollment Period Runs to Dec. 15

TRENTON – Gov. Phil Murphy, Department of Banking and Insurance Commissioner Marlene Caride and Treasurer Elizabeth Maher Muoio, Nov. 21, urged residents who need to enroll or re-enroll in health coverage to do so before the Affordable Care Act Open Enrollment deadline Dec.15. 
According to a release, Caride stated most residents shopping for coverage on the marketplace are eligible for financial help to lower the cost of their plan and reminded residents that there is a requirement to have health insurance in New Jersey or pay a penalty at tax time.
“The clock is ticking for residents to find a plan that meets their coverage needs before the Open Enrollment Period closes,” stated Murphy. “We have taken important steps to support the Affordable Care Act which have resulted in increased enrollment assistance for residents this year, but the state is still subject to the shortened six-week federal window to enroll in coverage. We are asking residents to review their options now to make sure they meet the enrollment deadline. Financial help is available for many residents and there are community organizations across the state ready to help with enrollment. We urge New Jersey families who need coverage to take advantage of this assistance to get the coverage they deserve.” 
“We know that the holidays are coming, and that important priorities are often pushed off until after the holiday rush. As we reach the midway point in the open enrollment period, we are urging residents not to delay enrollment. I cannot emphasize enough that for many financial help is available to lower the cost of health plans. We also want to remind residents that it is the law in New Jersey to have health insurance or you will pay a penalty at tax time,” stated Caride. “We do not want anyone to pay the penalty when they can have coverage. If you have not begun reviewing your plans and shopping for coverage, this is the time to get started.
“With just a few weeks left for open enrollment, the time to act is now. We want to remind residents that having adequate healthcare coverage is not only smart, it’s the law in New Jersey. While the process can often feel overwhelming, it’s important to remember that there are numerous resources available to help guide residents in selecting a plan that’s right for them,” stated Muoio. “Our goal is to ensure that families have adequate coverage to safeguard their health in times of need and that they also avoid incurring the legally mandated Shared Responsibility Payment when it comes time to file their 2019 taxes.”
This year residents will benefit from increased enrollment services due to the state’s move to a State-Based Exchange on the Federal Platform.
The Department of Banking and Insurance recently announced the award of navigator grants to five organizations totaling $1.1 million to provide enrollment assistance to residents shopping for health coverage during this year’s open enrollment period.
The department also introduced a new health plan comparison tool this year that allows residents to easily compare health plans on and off the exchange and their monthly costs and determine if they qualify for financial assistance. 
The tool is available on the state’s Get Covered New Jersey website, GetCovered.NJ.gov, and is part of enhanced efforts by the state to ensure residents have the assistance they need to get covered.
Last year, about eight out of 10 residents who shopped for a health plan on the marketplace received financial assistance to lower the cost of their plan. Nearly 200,000 residents received a tax credit to help pay for their plan in 2018, with the average person saving $366 a month. 
In New Jersey, a family of four earning up to about $103,000 a year and an individual earning up to about $49,960 a year can qualify.
As they shop for health coverage, the department encouraged residents to be mindful of so-called “skimpy” health plans with limited coverage which are prohibited in the state because they are not comprehensive and do not provide the essential health benefits required by the ACA. These include short-term limited-duration plans, which provide limited benefits and commonly feature pre-existing condition exclusions.
Rules by the Trump administration to expand the use of short-term plans have raised concerns that consumers might confuse these skimpy plans for plans that are ACA compliant. 
Short-term health plans are prohibited in New Jersey. Residents shopping for health insurance should also be mindful of health care sharing ministries. 
While these plans are not prohibited in New Jersey, residents should understand that these plans are typically limited in coverage and often do not provide comprehensive benefits. 
The department is encouraging residents who are unsure about whether a health plan meets the requirements of state and federal law to call the department’s Consumer Hotline at 1-800-446-7467 (8:30 a.m. to 5:00 p.m. EST Monday through Friday). If residents want to file a complaint, they may do so via the hotline or by going to the department website and clicking on Consumer Assistance – Inquiries/Complaints, at https://www.state.nj.us/dobi/index.html.
Information on the Open Enrollment Period as well as phone and in-person assistance may be found on the Get Covered New Jersey website at GetCovered.NJ.gov.