N.J. Requires Residents to Have Health Insurance

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Starting January 1, 2019 most New Jersey residents will be required to have health insurance containing minimum essential health coverage or be penalized with a tax.  

The penalty is to be calculated based on the current Affordable Care Act formula, which calls for a tax of 2.5 percent of an individual or family’s income, or $695 per adult and $347 per child -  whichever is greater - for a maximum family penalty of $2,085. The penalty is designed to increase each year that someone is not covered but can’t exceed the price of a lower-cost “bronze-level” health plan, which averaged just under $3,300 in 2017, and has been increasing at close to 10 percent annually.

Minimum essential coverage is the same as required by the Affordable Care Act and will include, among other things, doctors' services, inpatient and outpatient hospital care, prescription drug coverage, pregnancy and childbirth and mental health services.

Similar to the Affordable Care Act, employers that provide health coverage will submit documentation to employees and the Treasurer as proof of coverage, including the name, address and Social Security number or taxpayer identification number of the primary insured and the name, Social Security number or taxpayer identification number of each other individual obtaining coverage under the policy, and the dates during which that individual was covered under minimum essential coverage during the calendar year.

The Treasurer is required to issue regulations. An obvious point of clarification will be how an employer is to obtain the personally identifiable information from dependents.

Commentary on EANJ Blog