Best Individual Health Insurance Nj - New Jersey Health Insurance Marketplace Guide 2023 Aetna Joins New Jersey Stock Exchange in 2023; The simplified registration program will be used from early 2024
New Jersey operates its own exchange platform (GetCoveredNJ). Aetna joined the exchange in 2023, bringing the number of insurers offering plans through the exchange to five.
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Enrollment hit a new record high for 2022 when 311,692 people signed up for private individual market plans during open enrollment through the New Jersey Stock Exchange.
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New Jersey's new state-funded bounty grants (available in 2021) have been extended to more households.
New Jersey passed legislation to create a "simple enrollment" program that would be operational by early 2024 to help uninsured individuals link to health insurance through their state tax returns.
From 2014 to 2020, New Jersey used state-operated exchanges, meaning residents are enrolled in exchange plans through HealthCare.gov. But New Jersey said goodbye to HealthCare.gov at the end of 2020 and now operates its own exchange platform through the website GetCoveredNJ.
From fall 2013 through plan year 2020, New Jersey used HealthCare.gov like most other states. But in March 2019, Gov. Phil Murphy told CMS that New Jersey plans to begin operating its own health insurance exchange by the 2021 plan year (that is, by November 2020).
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But New Jersey has also sought CMS approval for the NJ Department of Banking and Insurance to oversee the exchange starting in late 2019, where people buying 2020 coverage. The application was approved weeks before open enrollment for 2020 health plans began, so New Jersey had a state exchange through the federal platform (HealthCare.gov) for the 2020 plan year. The state transitioned to a fully state-run exchange in late 2020, using its own registry platform (GetCoveredNJ) instead of HealthCare.gov.
State exchanges using the HealthCare.gov enrollment platform charged a 2.5% fee on premiums in 2020, rising to 3% in 2019. So New Jersey paid that 2.5% fee in 2020. But now that the state has its own exchange, they plan to. To continue charging the same 3.5% fee charged by the federal government in 2019. But instead of sending them to the federal government, New Jersey will use the money -- an estimated $50 million a year -- to run a state stock exchange.
By operating its own stock exchange, New Jersey gained significantly more control. The state has flexibility to extend open registration (registration continues through January 31 in New Jersey), direct the state's registration and outreach in the most meaningful way, design a registration website and customer service center, and make more restrictive plans. Sell in the market.
Five insurers are offering plans through the New Jersey Stock Exchange for coverage through 2023. That includes the new Aetna for 2023, along with four insurers that already offer plans through 2022. For 2023 coverage, plans are available on the New Jersey Stock Exchange from the following insurers:
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Oxford also offers individual market plans in New Jersey, but off-exchange (no financial assistance is available off-exchange, so anyone who buys an Oxford plan pays full premiums and is not eligible for out-of-pocket assistance. At any rate).
As in most states, insurer participation in the New Jersey stock market has varied over the years. As of 2014, only three insurance plans are offered: Horizon Blue Cross Blue Shield, AmeriHealth, and Health Republic of New Jersey (Freelancer CO-OP). But in 2015, Oscar and Oxford joined the exchange. Since then there have been some other changes as well:
Open enrollment takes longer in New Jersey than in most other states. It runs from November 1 to January 31 (in most states it ends on January 15). The flexibility to extend open enrollment is because New Jersey now operates its own exchange platform (GetCoveredNJ).
Outside of the open enrollment period, New Jersey residents can enroll or make changes to their coverage if they qualify for a special enrollment period. In most cases these require a qualifying event, although Native Americans do not require qualifying events.
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And New Jersey also allows a special enrollment grace period due to pregnancy, which is only available in some other states.
In 2023, average premiums in New Jersey's individual market increased by 8.8%, with the following average rate changes for each insurer:
. Most New Jersey Exchange participants receive award grants that offset a significant portion of their monthly expenses. For these participants, net price changes from one year to the next (after subsidy) depend on how much the subsidy changes and how much their own plan's tariff changes. Subsidy amounts change as the price of the benchmark plan changes. This may happen because existing plans change their prices, new insurers move into an area, or take a benchmark position.
New Jersey's federally funded premium grants are available through 2023 to families earning up to 600% of the poverty line. Upgraded federal premium grants are also available through the American Rescue Plan. With the two programs, 9 out of every 10 enrollees through GetCoveredNJ in 2023 will be eligible for financial assistance through GetCoveredNJ, and for most people $10/month (this plan or individual's specific needs may not be the best choice).
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Average rate changes also do not take into account the fact that premiums increase with age. Even if your insurer's average premiums don't change from year to year, you'll pay a higher premium because you're an extra year older. For recipients of contribution subsidies, subsidies increase as age-related contributions increase.
Oxford (UnitedHealthcare) offers only over-the-counter plans in New Jersey. Their average rate increased by 8.2% in 2023. Subsidies are not available to cover the cost of over-the-counter coverage.
For guidance, here's a summary of how average individual/family health insurance rates in New Jersey have changed over time:
In July 2020, New Jersey enacted A.4389 (Senate version S.2676) to reduce the state's uninsured rate, close racial disparities in health care, and make individual health insurance more affordable.
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The law, signed by Governor Murphy on July 31, is expected to replace the ACA's health insurance tax (which expires in late 2020) with a new state assessment of individual and fully insured health insurance to provide $224 million in annual funding. Plans for large groups in New Jersey through 2021.
One-third of the money raised by the assessment will be used to continue to fund the state's existing reinsurance program. The other two-thirds will be used to make health insurance more affordable for people with low and moderate incomes. Maura Collingrew, director of health programs for New Jersey Citizen Action, explained that the money will be used to provide state-funded premium grants that go hand-in-hand with federal grants provided by the ACA.
Originally, state-funded subsidies were available to families with incomes up to 400% of the poverty line, which was the eligibility threshold for federal subsidies. But the US bailout removed the income threshold for eligibility for federal subsidies in 2021 and 2022, and the Deinflation Act extended it until 2025 (ie, no more "subsidy cliff" for those two years). Beginning in May 2021, New Jersey announced that federally funded subsidies will be available to families with incomes up to 600% of the poverty line. The same applies in 2023.
New Jersey's state-funded subsidies are designed to counteract the fact that health insurance -- robust coverage with low out-of-pocket costs -- can often be expensive even with state subsidies. The American Rescue Plan made coverage more affordable for nearly all income levels, and New Jersey is expanding the range of state-funded subsidies to continue making coverage as affordable as possible.
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According to a statement from Governor Murphy's office, the subsidy amount must be at least $564 per enrollee in 2021. In the first five weeks of open enrollment, she averaged $556 in total annual savings, excluding federal award subsidies for which individuals are eligible; The details changed in 2021 when the state decided to provide higher-income subsidies.
As Andrew Sprung explains, New Jersey's state-funded subsidy amounts are based on income. But unlike federal subsidies for low-income earners, New Jersey's state-funded subsidies are larger for high-income earners.
Legislation originally called for the new tax to be set at 2.75% of premiums, but later changed it to 2.5% (which is less than what insurance companies pay under the ACA's health insurance tax, according to New Mexico, which had a similar law under consideration there earlier this year).
The rating applies only to individual market plans and fully insured large group plans
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