Home Understanding New Jersey Health Insurance Mandate

What is the New Jersey Health Insurance Mandate?

The state of New Jersey (NJ) mandates that all employers, insurers and other coverage providers report health insurance information. This mandate applies to both in-state and out-of-state coverage providers if they have NJ residents covered under the offered plan.

What forms must be filed with New Jersey?

The state accepts the following forms:

  • NJ-1095 forms,
  • Fully completed Federal Form 1095-A,
  • 1095-B and 1095-C forms, and/or
  • 1095-C forms with Parts I and III completed.

Please note: 1095-C forms with only Part I and II completed will NOT meet any NJ filing requirements. These should only be included in a filing with other forms that do meet the NJ filing requirements.

ACA filing requirements

Who must submit ACA data to the state of NJ?

Filing requirements vary depending on the size of the company and whether they offer fully-insured, self-insured, or a participant in a multiemployer plan.

As a reminder:

  • Applicable Large Employers (ALEs) are employers with 50 or more full-time and full-time equivalent employees during the prior calendar year.
  • Non-ALEs are employers with fewer than 50 full-time and full-time equivalent employees during the prior calendar year.

Fully Insured

  • Single-Company, ALEs & Non-ALEs - Typically, the health coverage provider (insurer) completes a fully completed Form 1095-B or NJ-1095 for each covered member. However, if the insurer fails to meet the filing requirements, then the employer is obligated to send the ACA data.
  • Fully Insured Employers that participate in a Multiemployer Plan - Typically, a plan sponsor files a Form 1095-B or NJ-1095 for those who are enrolled. If the plan sponsor fails to meet the requirements, then the employer must complete the ACA filing itself.

Self-Insured

  • Single Company, ALEs - Employers must file a fully-completed 1095-B, 1095-C or NJ-1095 for each person who was full-time for at least one month and for any employee that was enrolled in the plan.
  • Single Company, Non-ALEs - The employer must file a 1095-B or NJ-1095 for each covered employee.
  • Self-insured Employers that participate in a Multiemployer Plan - A plan sponsor typically files Forms 1095-B or NJ-1095 for each covered employee.
ALE explained

How can employers file with New Jersey?

Employers and coverage providers can send their ACA data in the IRS XML format, as long as the files are the fully completed Forms 1095-B or 1095-C. Pipe delimited flat text format can also be used.

There is no paper filing option available.

What are the ACA deadlines for NJ??

Deadlines for New Jersey ACA filings are as follows:

  • The deadline to furnish forms to recipients is March 1st
  • The deadline to file your New Jersey ACA forms is April 2nd
New Jersey filing formats

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