Open enrollment period begins Nov. 1 for new state-run health care exchange

The Affordable Care Act open enrollment period in New Jersey begins on Sunday, Nov. 1 and runs through Jan. 31.

New Jersey residents will no longer use HealthCare.gov to enroll in Marketplace health insurance plans. Instead, Marketplace plans and financial help will only be available through New Jersey’s new state-run health care exchange, Get Covered New Jersey, at getcovered.nj.gov.

The state established its own health insurance marketplace in order to secure better access to health care for New Jersey residents. New state subsidies are available under a law signed by Gov. Phil Murphy in 2019. Officials estimate that about eight in 10 people purchasing health insurance coverage through the state will qualify for subsidies.

Get Covered New Jersey offers health insurance plans for residents who do not have coverage through an employer or other program. It is the only place New Jersey residents can get financial help to purchase a plan.

Residents in need of health coverage for 2021, and residents with coverage through  Healthcare.gov who want to change their health plans will be able to enroll in a health insurance plan through getcovered.nj.gov. Residents currently enrolled in a health plan through Healthcare.gov will be automatically transitioned to Get Covered New Jersey.

Residents shopping for health insurance on Get Covered New Jersey must enroll by Dec. 31 for coverage to start Jan. 1. Coverage will become effective Feb. 1 for those who enroll by Jan. 31.

In addition to the federal tax credits, the new state subsidy called New Jersey Health Plan Savings will be available to residents with incomes of up to 400 percent of the federal poverty level (residents with incomes up to $51,040 a year, or up to $104,800 for a family of four). Officials said the subsidies will help reduce premiums for new enrollees, and residents with existing health plans through the federal Marketplace. The subsidies will start lowering premiums for coverage that starts Jan. 1 or after.

The state has expanded the open enrollment period to three months from the six-week window that was available in recent years under the federal government. The program is being operated by the New Jersey Department of Banking and Insurance. All plans offered through GetCovered.NJ.gov cover the 10 essential health benefits required under the Affordable Care Act, including preventive services, emergency services, prescription drugs, and prenatal and pediatric care. No one can be denied coverage due to a pre-existing condition. The same health insurance companies that offered plans on Healthcare.gov are participating in Get Covered New Jersey.

In New Jersey, the requirement to have health coverage remains. Residents who do not qualify for an exemption from the Shared Responsibility Payment will pay a penalty at tax time, officials said.