Alternatives to Individual New Jersey Health Insurance Coverage

Some Alternatives to Individual Health Coverage

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

COBRA or State Continuation

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. You will be required to pay the full premium, and may be required to pay a 2% administrative fee. 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. The rate charged for COBRA and State continuation coverage is the group rate, which is often lower than an individual rate.

If you were covered under a group plan as a dependent and lost that coverage due to death of the employee, divorce, or you ceased to meet the dependent eligibility standards under the plan, you may elect to continue your coverage for up to 36 months. You will be required to pay the full premium for single coverage, and may be required to pay a 2% administrative fee. Your coverage will be the same as you had while covered as a dependent. The rate charged for COBRA and State continuation coverage is the group rate, which is often lower than an individual rate.

Information regarding New Jersey Continuation is provided in SEH Bulletin 07-SEH-02 and is available at www.state.nj.us/dobi/division_uinsurance/ihcseh/sehbulletins.htm

Continuation of Coverage for Dependents Under 31

New Jersey law (P.L. 2005, c. 375) permits certain children of persons 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 dependents who lost coverage under a group health benefits plan issued in New Jersey due to age who: are under 31 years old; are not married; have no children; are either residents of New Jersey or are full-time students; 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 health insurance program created to help New Jersey's uninsured children and certain low-income parents and guardians to have affordable health coverage. It is not a welfare program. NJ FamilyCare is for families who do not have available or affordable employer insurance, and cannot afford to pay the high cost of private health insurance.

Information about NJ FamilyCare is available by calling 1-800-701-0710 or by visiting the website: www.njfamilycare.org/

NJ FamilyCare Advantage

Eligibility for this program requires that the family:

1. Have been uninsured for at least 6 months;
2. Have a child or children under age 19; and
3. Meet household income and family size guidelines

Information about NJ FamilyCare Advantage is available by calling 1-800-637-2997 or by visiting the website: www.horizonnjhealth.com/members/advantage.html

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 full 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.