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Some Alternatives to the Coverage Described in this Buyer's Guide
NJ Individual Health Coverage Program Buyer's Guide


To find out if you might qualify for a subsidy to assist you with purchasing an individual policy, visit www.healthcare.gov.

Although you may be eligible to purchase an individual policy, you may want to consider alternatives that may be available to you.

 
COBRA or Small Employer Group Continuation

Both federal and New Jersey law require that most employees and dependents who lose coverage under an employer’s group health plan be given the opportunity to continue coverage under the group health plan for a period of time.  The federal law, usually referred to as COBRA, applies to most employers with 20 or more employees, while the New Jersey Small Employer Group continuation law applies to most employers with 2 to 50 employees.  The two laws are very similar.  Under both COBRA and New Jersey law, the person electing to continue coverage can be required to pay the full premium plus a 2% administrative fee; even so, group rates are often lower than an individual rate for a plan with similar benefits.
 
If you lost coverage under an employer group plan as an employee due to termination of employment or a reduction in hours, you may elect to continue your group coverage for up to 18 months.  Coverage will be the same as you had while covered as an active employee, and any dependents who were covered under your plan may also be covered under your continued coverage.  

If you were covered under a group plan as a dependent and lost that coverage due to death of the employee, divorce, or because you no longer meet the dependent eligibility standards under the plan, you may elect to continue your coverage for up to 36 months.  Your coverage will be the same as you had while covered as a dependent. 

Information regarding New Jersey’s Small Employer Group Continuation is provided in SEH Bulletin 07-SEH-02
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Continuation of Coverage for Dependents Under 31

New Jersey law (P.L. 2005, c. 375) permits certain children of people covered under group health benefits plans the opportunity to maintain dependent coverage after reaching the limiting age specified in the group plan.  The law applies to a covered employee’s children who no longer meet the age requirements to be a child dependent under the group health coverage who also: are under 31 years old AND are not married AND have no children AND are either residents of New Jersey or are full-time students if not living in New Jersey AND are not actually covered under any other health benefits plan. 

Information about coverage under this law is available on the Department of Banking and Insurance website: www.state.nj.us/dobi/division_consumers/du31.html
 
NJ FamilyCare

NJ FamilyCare is a federal and state funded program created to provide New Jersey's uninsured children 18 years old and younger and certain low-income parents and guardians free or low-cost health coverage. Eligibility is based on a family’s size and monthly income. Most children are required to have been uninsured for 3 months before enrolling in NJ FamilyCare, but there are exceptions based on changed circumstances to a parent’s job, and some other reasons. NJ FamilyCare is under the New Jersey Department of Human Services. 

For more information about NJ FamilyCare or to get an application, call 1-800-701-0710 or visit the website: www.njfamilycare.org (where you can download or complete an application online).
 
Federally Qualified Health Centers

Although not health insurance, Health Centers are a way for people without health coverage to access quality medical care.  Located in various parts of the state, Health Centers are staffed with medical providers to enable them to provide a wide range of medical care.  The Health Centers will charge patients for the care provided using a sliding fee scale based on the patient’s income.

As an attachment to the rate comparison sheet we include a list of the Heath Centers with their phone numbers. 

   
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OPRA
OPRA is a state law that was enacted to give the public greater access to government records maintained by public agencies in New Jersey.
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New Jersey Department of Banking and Insurance