New Jersey Health Insurance

Like many states on the east coast, New Jersey has passed laws to carefully regulate its resident health insurance industry.  These regulations make the local health insurance market particularly consumer-friendly, but that doesn’t mean that you should approach them without first learning about what insurers can and can’t do when administering your policy.  The list below outlines the most important regulations and guarantees to know about when shopping for health coverage in New Jersey.

• Every health insurance policy sold in New Jersey must include a guaranteed-renewability clause.  This provision requires the insurer to let you renew your policy when it is due to expire, as many times as you see fit.  This assumes that you have likewise kept to the terms of the policy, of course, and made sure to pay all premiums on time.  You are also protected from having your coverage involuntarily cancelled by your insurer due to health complications.
• Any health issue that is present up to six months before starting new coverage can potentially be designated a “pre-existing condition” by the administrator of your policy, making any costs arising from that condition, for a period of up to twelve months, exempt from being covered by your insurance.  Of course, maintaining continuous coverage over the months prior to moving onto your new policy can prevent this problem.
• Insurers in New Jersey are permitted to deny applications for new health insurance policies, but this refusal cannot be predicated on factors like health, age, gender, and so on; these characteristics are also prohibited from being considered when determining the cost of any person’s health policy.  Finally, even if your application is ultimately rejected for some other reason, you always have the option of buying coverage from Blue Cross Blue Shield if you are a New Jersey resident.
• Every small business in New Jersey is automatically eligible to purchase group health coverage from any insurer they choose, provided that the business in question has at least two (and no more than fifty) employees.  The policies they are offered must be the same as, or closely comparable to, group health insurance enjoyed by other New Jersey small businesses.
• It may be necessary for employers to keep at least a certain percentage of their staff enrolled in the company health plan at all times, and/or to contribute a certain amount toward each employee’s premiums.  Failure to do this could mean termination of the company’s coverage, depending on the specific stipulations of the policy.
• As with individual health insurance, a small business’s group coverage cannot be cancelled on the grounds of poor health among those insured, and the rates charged for the policy cannot take traits like age, gender, and health status into account.
• If you are self-employed, the state of New Jersey will only allow you to purchase group health coverage if you have at least one other employee, just like any other small business.  Lone entrepreneurs still have the option of buying individual health coverage, of course, and if you plan to itemize your deductions you may be able to deduct a sizable portion of the premiums from your tax liability.

Even in relatively consumer-friendly insurance markets like New Jersey, there is much to be gained by those willing to devote a modicum of time and effort to finding a good deal.  Comparing rates between competing companies and carefully reading over policy details will often pay huge dividends by leading you toward a health plan that fits your needs at an excellent price, and any time you spent would then be repaid in full by the savings you enjoy afterward.

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