Calculate Your Monthly Small Employer Health (SEH) Premium. The rates that will be displayed are the rates for plans with effective dates in the " + Date_of_Rates.






*Required Field
Data should be entered into this table for each employee (and their dependents, if any). All entered ages are as of the effective date. After entering data for each employee, click on the ‘SAVE RECORD’ button below. Then click on the ‘NEW’ button to add data for all other employees. When you have entered data for all employees, click on the ‘Check Input Fields’ button to identify any errors. If all the data is okay [no errors found], click on the ‘Calculate the SEH Monthly Premium’ button.
Name:
Spouse Covered: Yes
No
Employee Age: *Required Field
Number of dependent children aged 20 or less that will be covered:
Number of dependent children aged 21 that will be covered:
Number of dependent children aged 22 that will be covered:
Number of dependent children aged 23 that will be covered:
Number of dependent children aged 24 that will be covered:
Number of dependent children aged 25 that will be covered:
Number of dependent children aged 26 that will be covered:
Number of dependent children aged 27 that will be covered:
Number of dependent children aged 28 that will be covered:
Number of dependent children aged 29 that will be covered:
Number of dependent children aged 30 that will be covered:
Comments:
















 
Contact the carriers directly for more information


Carrier Name  Web Address Phone Number
Aetna Life Ins. Co. and Aetna Health, Inc. www.aetna.com 1-888-277-1053
AmeriHealth HMO Inc. and AmeriHealth Ins. Co. www.amerihealth.com 1-866-681-7368
Cigna HealthCare of NJ and Cigna Health and Life Ins. Co. www.cigna.com/brokersandconsultants/cigna-broker-contacts-small-group 1-800-456-6575
Health Republic Ins. Co. of NJ
newjersey.healthrepublic.us 1-888-990-5706
Horizon Blue CrossBlue Shield of NJ and Horizon Healthcare of NJ www.horizonblue.com 1-800-224-1234
Oxford Health Ins. (NJ), Inc. and Oxford Health Plans (NJ), Inc www.oxhp.com 1-800-449-8880
For information on small employer tax credits, visit: www.healthcare.gov