New Jersey Creates an extended Covid Open Enrollment Period

Bressler, Amery & Ross, P.C.

The New Jersey Department of Banking and Insurance (“Department”) extended open enrollment and to create an extended COVID-19 Special Enrollment Period (“SEP”) to be in effect beginning at the end of the annual open enrollment period, on February 1, 2021 and extending through May 15, 2021. Specifically, the SEP will make sure that individual market coverage is available to uninsured individuals during the pandemic. It also aligns New Jersey with the recently announced federal Special Enrollment Period which runs through May 15, 2021. The mandate applies to Get Covered New Jersey, the state insurance exchange codified at N.J.S.A. 17B:27A-57 to -59.  In addition, the Department coordinates Get Covered New Jersey with the operations of the New Jersey Individual Health Coverage Program. Federal regulations set forth a range of circumstances in which Qualified Health Plans (“QHPs”) offered through the Marketplace must permit qualified individuals, as well as dependents, to receive special enrollment periods (“SEPs”) to enroll in the Individual Exchange. 45 CFR §§ 155.420(d), 155.725 (j), and 155.726(c). These federal rules also permit Exchanges to define “exceptional circumstances” for SEPs. See 45 C.F.R. §§ 155.420(d)(9), 155.725(j), and 155.726(c).

During this COVID-19 emergency SEP, individuals that are not already enrolled in an individual health benefits plan can apply for coverage through Get Covered New Jersey or directly through carriers. No additional information or documentation is required to be eligible for the 2 SEP. Similar to applicable existing SEPs, which remain in place, through this COVID-19 SEP individuals already enrolled in a health benefits plan who are seeking to replace current coverage with a different health benefits plan may do so. Individuals enrolled under this COVID-19 SEP will have coverage effective no later than the first of the next month after their date of enrollment.

DISCLAIMER: Because of the generality of this update, the information provided herein may not be applicable in all situations and should not be acted upon without specific legal advice based on particular situations.

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