Small Employer Health Coverage Program

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Small Employer Health Coverage Program

Shopping for Health Insurance

Rates for Small Employer Health Plans (Effective: January 1, 2006)
Small Employer Health Carriers (Addresses and Telephone Numbers)

Small Employer Health Benefits Buyer's Guide (PDF)
Statute Citation

SEH Meeting Notices

SEH Program Board Minutes (All files are PDFs)

Meeting Schedule

20088		02/20/08
2007		12/19/07 > 11/07/07 > 09/19/07 > 08/01/07 > 06/13/07 > 04/25/07 > 03/07/07 > 01/17/07
2006		12/13/06 > 10/25/06 > 09/20/06 > 08/09/06 > 06/28/06 > 05/03/06 > 04/07/06 > 03/22/06 > 01/18/06
2005		11/21/05 > 11/16/05 > 10/19/05 > 09/21/05 > 08/31/05 > 07/13/05 > 05/25/05 > 04/20/05 > 02/16/05 > 01/12/05
2004		11/17/04

SEH Program Standard Plans

SEH Reporting Forms

NOTE: Below are standard forms for new issues and renewals occurring on or after 10/1/04.

Explanation of Brackets for all Plans (PDF)
Small Employer Plan A (Basic Policy) - Policy (MS Word)
Small Employer Plan A (Basic Policy) - Certificate (MS Word)
Small Employer Plans B, C, D, E - Policy (MS Word)
Small Employer Plans B, C, D, E - Certificate (MS Word)
Rider For Prescription Drug Insurance (MS Word)
Small Employer Application (MS Word)
Small Employer HMO Plan - Evidence of Coverage (MS Word)
Small Employer HMO Plan - Contract (MS Word)
Small Employer HMO Point of Service - Evidence of Coverage (MS Word)
Small Employer HMO Point of Service Plan - Contract (MS Word)
Small Employer Certification (MS Word)
Small Employer Open Face Rider (MS Word)

SEH Exhibit BB, Part 1: Certification of Compliance (MS Word)
SEH Exhibit BB, Part 1: Certification of Compliance (MS Excel)
SEH Exhibit BB, Part 2: Certification of Promotional and Marketing Material (MS Word)
SEH Exhibit BB, Part 6: Use of Optional Benefit Riders (MS Word)

SEH Program Assessments/Reconciliations

1993-1999 Final Assessment Reconciliations
(MS Excel)

SEH Loss Ratio Reports

2006

SEH Program Bulletins

SEH Program Rule Proposals/Adoptions

Bulletin 07-SEH-02 (PDF) - State Continuation of Coverage
Bulletin 07-SEH-01 (PDF) - Civil Unions (P.L. 2006, c103)
Bulletin 06-SEH-03 (PDF) - Adopted Amendments to provide provisions specifying coverage for over-age dependents
Bulletin 06-SEH-02 (PDF) - High Deductible Health Plans offered in Conjunction with a Federally Qualified Health Savings Account
Bulletin 06-SEH-01 (MS Word) - Adopted Amendments to Standard Health Benefit Plans to comply with Federal Law and to Address Participation Credit for Medicaid and NJ FamilyCare
Bulletin 05-SEH-03 (PDF) - Continuation Rights Policy Form Text 3
Bulletin 06-SEH-02 (PDF) - What Constitutes “Offering” Coverage; Carriers Issuing Plans to Small Employers That Already Have Coverage; Carriers Issuing Coverage to New Jersey Small Employers with Out-of-State Employees
Bulletin 05-SEH-01 (PDF) - State Continuation of Coverage Amendments
Bulletin 04-SEH-03 (PDF) - Plans Available to Small Employers
Bulletin 04-SEH-02 (PDF) - Policy Form Changes Operative October 1, 2004
- Chart (PDF)
Bulletin 04-SEH-01 (PDF) - Impact of Policy Form Changes to Existing Plans, Options, and Riders
- SEH Optional Benefit Rider Certification and Checklist (PDF)
Bulletin 02-SEH-01 - Producer Compensation Arrangements
SEH Carrier Filing Deadlines (PDF)
Bulletin 98-SEH-06 - State Continuation of Coverage
Bulletin 98-SEH-07 - Coverage for Treatment of Sexual Dysfunction
Bulletin 98-SEH-08 - Amendments to Standard Health Benefits Plans
Bulletin 98-SEH-09 - Amendments to Regulations Governing SEH Market
Bulletin 99-SEH-01 - Bulletin Certification of Compliance
Bulletin 99-SEH-04 - Coverage For Intensive Outpatient Services
Bulletin 99-SEH-05 - HMO-based Coverage for Home Health Care and Private Duty Nursing
Bulletin 99-SEH-06 - Adoption of Changes to Standard Small Employer Health Benefits Plans Text to Include on Compliance and Variability Rider
Bulletin 99-SEH-07 - Termination of a Policy or Contract and Collection of Premium
Bulletin 00-SEH-02 - Professional Employer Organizations/Employee Leasing Companies
Bulletin 00-SEH-03 - Coverage For Home Health Care and Private Duty Nursing

Proposed Amendments to the Standard Plans and Regulations to Address Coverage Required by P.L. 2006, c. 103 Relating to Civil Union Partners (PDF)
Adopted Amendments to the Standard Plans and Regulations to Address Coverage Required by P.L. 2006, c. 103 Relating to Civil Union Partners (PDF)
- Policy Plan A (MS Word)
- Certificate Plan A (MS Word)
- Policy Plans B - E (MS Word)
- Certificate Plans B - E(MS Word)
- HMO Contract (MS Word)
- HMO Evidence of Contract (MS Word)
- HMO-POS Contract (MS Word)
- HMO-POS Evidence of Contract (MS Word)
Over-Age Dependent Coverage Proposal
(PDF)
Over-age Dependent Coverage Adoption
(PDF)
- Over-Age Dependent Rider (MS Word)
- Standard Plans (with proposed text included)
  - Policy Plan A (MS Word)
  - Certificate Plan A (MS Word)
  - Policy Plans B-E (MS Word)
  - Certificate Plans B-E (MS Word)
  - HMO Contract (MS Word)
  - HMO Evidence of Coverage (MS Word)
  - HMO-POS Contract (MS Word)
  - HMO-POS Evidence of Coverage (MS Word)
Proposed amendments to comply with Federal Law and Participation Credit for Medicaid and NJ FamilyCare (PDF)
Adopted amendments to comply with Federal Law and Participation Credit for Medicaid and NJ FamilyCare (PDF)
- Policy Plan A (MS Word)
- Certificate Plan A (MS Word)
- Policy Plans B-E (MS Word)
- Certificate Plans B-E (MS Word)
- HMO Contract (MS Word)
- HMO Evidence of Coverage (MS Word)
- HMO-POS Contract (MS Word)
- HMO-POS Evidence of Coverage (MS Word)
SEH State Continuation Adoption (PDF)
SEH Withdrawals of Standard SEH Plan of Operation Benefit Riders (PDF)
SEH Adopted Readoption with Amendments - SEH Board (PDF)
SEH Proposed Readoption with Amendments
- Summary and Rules (PDF)

Small Employer Purchasing Alliance adopted rule (PDF)

April 2008

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