Governor Phil Murphy

ICYMI: New Jersey Will Provide $2 Million in Navigator Grants & Outreach Funding to Assist New Jerseyans with ACA Enrollment

10/3/2019

From the New Jersey Department of Banking and Insurance:

New Jersey Authorized as State-Based Exchange on the Federal Platform


TRENTON – The New Jersey Department of Banking and Insurance today announced the state will dedicate up to $2 million in grant funding for state Navigators and other organizations to provide enrollment assistance to New Jersey residents shopping for health coverage during this year’s open enrollment period, as part of the state’s move to a State-Based Exchange on the Federal Platform. The Affordable Care Act open enrollment period for plan year 2020 runs from November 1, 2019 to December 15, 2019.         

The increased investment beyond what the federal government would have provided in funding for outreach is part of the state’s ongoing work to improve access to quality affordable coverage for New Jersey residents. In June, Governor Phil Murphy signed legislation to establish a State-Based Health Exchange in New Jersey. As part of the transition, the state will operate a State-Based Exchange on the Federal Platform (SBE-FP) for plan year 2020 and a State-Based Exchange (SBE) for plan year 2021.

“New Jersey’s transition to a State-Based Exchange will allow the state to build on efforts already made to improve access to health coverage. Through the establishment of a State-Based Exchange on the Federal Platform, we are able to demonstrate a greater commitment and investment in outreach and enrollment assistance that the federal government has refused to provide in recent years. This means that for the approaching Open Enrollment Period we can connect more New Jerseyans to information about coverage and ensure that residents who need help enrolling or re-enrolling in health coverage will have the support they need,” said Department of Banking and Insurance Commissioner Marlene Caride. “This is yet another step forward in the Murphy Administration’s work to protect access to health coverage and to ensure that families in our state get the care they depend on and that they deserve.” 

The Department was notified by the U.S. Centers for Medicare and Medicaid Services on September 24th of authorization to serve as a State-Based Exchange on the Federal Platform. While an SBE-FP is responsible for activities such as certifying qualified health plans (QHPs), managing assister programs, and providing stakeholder outreach and education, the SBE-FP still relies on the Federally-facilitated Exchange’s (FFE) information technology systems, FFE consumer call center, and FFE eligibility and enrollment services through HealthCare.gov.

The Department will make available up to a total of $2 million in grant funding for state Navigators and outreach projects run by Certified Application Counselor Designated Organizations. Eligible organizations are:        

  • Organizations that previously served as Navigators in the state. Navigators will help consumers enroll and re-enroll in a health insurance plan through the State-Based Exchange on the Federal Platform. The organizations will provide outreach and education services, in addition to enrollment assistance.
  • Organizations serving as Certified Application Counselor Designated Organizations (CDOs), which oversee Certified Application Counselors. Funding will be available to CDOs to conduct outreach projects to assist in connecting New Jersey residents to quality affordable coverage. Eligible CDOs for this grant must have served as a CDO in New Jersey in 2019 and must be designated by the state to serve as a CDO in 2020. Former federal Navigators in New Jersey that choose not to apply for Navigator funding are also eligible to apply for CDO Outreach Project Grant funds. All applicants for CDO outreach project funding must apply for and receive designation by the state to serve as a CDO.

As an SBE-FP, the state is assuming operation of the Navigator and the Certified Application Counselor programs for 2020, and all assisters will be required to obtain certification from the state. Due to the transition to an SBE-FP, the state is able to increase its investment in outreach beyond the funding that would have been available to the state under a Federally-facilitated Exchange. CMS awarded a total of $10 million in navigator grant funding nationally to Federally-facilitated Exchange states. New Jersey was set to receive $300,000 in federal funding for 2020, reduced from $400,000 in funding made available to the state last year.

As part of the $2 million grant funding, the Department is awarding $300,000 to the Center For Family Services (CFS) to continue serving as a Navigator for 2020. CFS served as the state’s only federal Navigator in New Jersey in 2019 and was the sole New Jersey applicant for federal Navigator funding prior to the program transfer. As part of the transition, the Department accepted Center For Family Services’ federal application for state funding, and will permit the organization to apply for additional funds through the Request for Applications.

The $2 million grant program will be funded by the assessment authorized by P.L. 2019 c. 141.  

A Request for Applications for funding for the New Jersey State Navigator Program and Certified Application Counselor Designated Organizations (CDOs) Outreach Grant Program was released yesterday.

Additional information on the SBE-FP transition may be found here: https://www.state.nj.us/dobi/njexchange/index.html.