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The New Jersey Health Insurance Market Preservation Act requires every New Jersey resident to obtain health insurance, have a valid exemption, or make a Shared Responsibility Payment (SRP).
By encouraging more residents to get coverage, this law stabilizes New Jersey’s insurance market and reduces premiums, thus supporting the federal Affordable Care Act.
The law requires you and your family to have Minimum Essential Coverage (MEC) throughout the year, qualify for an exemption, or remit an SRP when you file your New Jersey Income Tax return.
New Jersey grants exemptions if you have a short gap in coverage, when premiums are unaffordable, or for other reasons listed on the Exemptions Page. Individuals who are not required to file a New Jersey Income Tax return are automatically exempt from the SRP and don’t have to file for an exemption.
Most basic health coverage satisfies State requirements, including insurance plans through an employer, Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and NJ FamilyCare. Plans that provide only limited benefits – such as vision or dental plans – do not. If you are not sure if your coverage qualifies as Minimum Essential Coverage, ask your health plan provider.
To enroll in health coverage for 2023, you must apply during the open enrollment period. Open enrollment for 2023 policies begins on Nov. 1, 2022. You can enroll after the open enrollment period only if you have an income or life changing event.
When you have coverage, you can indicate on your New Jersey Resident Return (Form NJ-1040) that you and your dependents have health care, and you will not be assessed a Shared Responsibility Payment.
The following types of health coverage satisfy the coverage requirement:
Any 2020 health plan bought through Healthcare.gov site or, for 2021 and beyond, any plan purchased through the GetCovered website.
Individual health plans bought outside the Health Insurance Marketplace, if they meet New Jersey’s standards for qualified health coverage. Plans must qualify as Minimum Essential Coverage, as required under the Affordable Care Act, as it was in effect on December 15, 2017. (See below for what constitutes Minimum Essential Coverage.)
Minimum essential coverage means health care coverage under any of the following programs. It doesn’t, however, include coverage consisting solely of excepted benefits. Excepted benefits include stand-alone vision and dental plans, workers' compensation coverage, and coverage limited to a specified disease or illness. Employer-sponsored coverage:
Group health insurance coverage for employees under:
A plan or coverage offered in the small or large group market in New Jersey.
A plan provided by a governmental employer, such as the Federal Employees Health Benefits program
A grandfathered health plan offered in a group market.
A self-insured health plan for employees
Coverage under an expatriate health plan for employees and related individuals
Department of Defense Non-Appropriated Fund Health Benefits Program.
Individual market coverage:
Health insurance you purchase directly from an insurance company
Health insurance you purchase through the Marketplace
Health insurance provided through a student health plan
Coverage under an expatriate health plan for non-employees such as students and missionaries
Coverage under government-sponsored programs:
Medicare Part A coverage
Medicare Advantage plans
Most Medicaid coverage
Children's Health Insurance Program (CHIP) coverage
Most types of TRICARE coverage
Comprehensive health care programs offered by the Department of Veterans Affairs
Health coverage provided to Peace Corps volunteers
Refugee Medical Assistance
Coverage through a Basic Health Program (BHP) standard health plan.
Coverage under a group health plan provided through insurance regulated by a foreign government if (1) a covered individual is physically absent from the United States for at least 1 day during the month, or (2) a covered individual is physically present in the United States for a full month and coverage provides health benefits within the United States while the individual is on expatriate status
Certain coverage provided to business owners who aren’t employees