Introduction to The New Jersey Individual Health Coverage Program Buyer's Guide

The New Jersey Individual Health Coverage Program Buyer's Guide: How to Select a Health Plan

In 1992, the New Jersey Legislature created the Individual Health Coverage (IHC) Program to ensure that people without access to employer or government sponsored health care programs could purchase health coverage for themselves and their families from a variety of private carriers. Prior to that time, few insurance companies offered policies to individuals and coverage was often inadequate, especially for people with chronic illnesses or injuries.

Today, individuals -- regardless of their age or health status -- are guaranteed renewable health coverage under standard individual plans designed by the Individual Health Coverage Program Board as well as under the Basic and Essential Plans sold by carriers.

This Buyer's Guide* provides general information on individual health benefits plans (referred to in this Buyer's Guide as individual plans) and is designed to help you shop for the plan that best meets your needs. Individual plans are available for a Single person, Two Adult, Family or Adult and Child(ren). To assist you with your plan selection, there is also a list of participating carriers, their current rates and their telephone numbers. The rate comparison sheets are updated monthly, providing rates for the current month, so please note the date that appears at the bottom of the rate sheet.

Individual plans may be purchased from a variety of carriers as either an indemnity plan (commonly known as a "traditional" or "fee-for-service" plan) or a managed care plan (a Health Maintenance Organization (HMO), Preferred Provider Organization (PPO) or Point-of-Service (POS)). The Basic and Essential Health Plan (B&E Plan) is also available as an Exclusive Provider Organization (EPO) plan. These plan options are explained in detail in this Buyer's Guide.

The law governing the Individual Health Coverage Program was significantly amended in 2009, and was generally effective January 5, 2009. The amendments affecting consumers are described in this 2009 edition of the Buyer's Guide.

You can learn more about the New Jersey IHC Program by browsing our Internet Web Address: http://www.state.nj.us/dobi/division_insurance/ihcseh/ihcmain.htm

* This Buyer's Guide provides only a summary of the New Jersey Individual Health Coverage Program requirements and is intended to help consumers make informed decisions concerning health coverage; contract provisions govern the terms and conditions of coverage.