Obtaining New Jersey Health Insurance Coverage

Obtaining Coverage

To obtain coverage, we suggest you follow these steps:

1. Review this Buyer's Guide to learn more about individual health coverage in New Jersey, the standard plans available, and the benefits they provide. The Basic and Essential Health Plan (B&E Plan) is not a standard plan, but this Guide will provide some general information concerning that plan and direct you to the carriers for more specific information on the B&E Plans they offer.
2. Review the list of participating carriers and the rate comparison sheets. For additional information, you may contact the carriers directly. You may also decide to contact a licensed insurance producer, sometimes known as an agent or broker, who can help you make an informed decision, at no additional cost to you. However, some carriers do not offer coverage through insurance producers, so you will have to contact those carriers directly.
3. Review the carrier's materials and select the carrier that best meets your needs.
4. Apply directly to the carrier you have selected by completing the application provided by that carrier. All carriers are required to use a standard application form (you may hear some carriers refer to it as the HINT form) so the application from one carrier should look very much like the application from another carrier.
5. Mail your completed application to the carrier. If your coverage will take effect within the next month, you must include the first premium payment with your application. Some carriers may allow you to authorize the carrier to deduct the premium payments from your checking account before the effective date. Check with the carrier you are selecting to find out if this is an available option.

Since coverage applied for during November as part of an Open Enrollment Period application does not take effect until the following January 1, the payment of the first premium either by check, or pre-authorized checking account deduction, may be delayed until December, even though you are applying in November.

Upon receiving your application and premium payment, your carrier will send you an identification card and a policy or contract which will indicate the effective date of your coverage. (Check the enrollment materials regarding the effective date of coverage. The effective date of coverage generally depends on the date of receipt of the completed application materials and premium payment.) If the ID card is not provided prior to the effective date of coverage, the carrier may suggest that you use a copy of your application as evidence of coverage.

You cannot be covered under two individual plans at the same time. If you currently have individual coverage, you must notify the current carrier, within 30 days after the new coverage takes effect that you want to terminate the current coverage. The current coverage will be retroactively terminated as of the day before the new coverage takes effect.

Generally, you cannot be covered under both an individual plan and a group plan. If you are currently covered under a group plan and are applying for an individual plan during the November Open Enrollment Period, that individual coverage takes effect on January 1. You must terminate the current group coverage no later than December 31. See the Group coverage section on the following page for information regarding eligibility for group coverage after you already have an individual plan.