On Thursday, April 9, New Jersey Governor Murphy issued  Executive Order 123 (EO 123) which outlines new guidelines for extending grace periods for premium payments on health and dental insurance plans in all market areas.

On Friday, April 10, The New Jersey Department of Banking and Insurance (NJDOBI) issued four bulletins with further guidance to be effective immediately. The bulletins layout new procedures that insurance carriers and brokers are required to follow to ease some of the financial strain being felt by employers and employees.

Individual Market: Bulletin 20-11

• Extends grace period to 60 calendar days for individual health benefits plans that do not receive advanced premium tax credits (APTC).
• Requires carriers to put in place a one-month delay before initiating the 90-day grace period for any policyholders that have missed a premium payment on health plans that do receive advanced premium tax credits (APTC). These delays may start retroactively to April 1 or May 1 as determined by the policyholder.
• Read the full bulletin here.

Small Employer Market: Bulletin 20-12

• Small employers that have group plans with renewal dates occurring during the month of March through the end of the state of emergency period must be deemed as eligible for renewal by the carrier. Carriers also must rescind any termination notices that may already have been sent to small employers for the month of March and through the end of the state of emergency period. Those small employers are also to be deemed eligible.
• Because carriers must keep all small employers with renewal dates occurring in March until the end of the state emergency period as eligible, participation requirements are being relaxed.
• Carriers must waive any re-hire waiting period that would apply to employees who were laid off after March 1, 2020 and became full-time employees eligible for health insurance under the small employer’s policy.
• Employees who are furloughed or temporarily laid off during this public health emergency are not required to be found ineligible due to not being actively at work. Employers who continue to cover furloughed or temporarily laid-off employees must remit the required premium for coverage to the carrier.
• Carriers must relax the full-time requirement so that employees whose hours have been reduced can maintain their coverage. This requirement only applies to employees who are currently covered and whose hours have been reduced. The employee may remain covered under the group policy without having to elect COBRA.
• The grace period is extended from 31 to 60 days to any small employer that requests it. This extension may start retro to April 1 or May 1 as determined by the policyholder.
• Read the full bulletin  here.

Large Employer Market: Bulletin 20-13

• Employers that have policies with renewal dates occurring during the month of March through the end of the state of emergency period must be deemed eligible for renewal by the carrier. Carriers must rescind termination notices that already have been sent to employers with renewal dates occurring in March and through the end of the state of emergency period. Those employers shall be deemed eligible. If a group wants to terminate its policy, the employer must submit a written termination letter to the carrier prior to the renewal date.
• Carriers may relax the full-time requirement to allow an employee to continue coverage. By relaxing the full-time requirements, the employee may remain covered under the group policy without having to elect COBRA.
• Carriers are required to waive any re-hire waiting period that would apply to employees who were laid off after March 1, 2020 and became full-time employees eligible for health insurance under the employer’s plan.
• Carriers shall make available an emergency 60-day grace period to any policyholder that has been financially or physically impacted by COVID-19.
• Read the full bulletin  here.

Medicare Supplements: Bulletin 20-14

• NJDOBI directs carriers to provide a 60-day grace period during which Medicare Supplement plans may not be terminated for nonpayment of premium. The grace period may be initially applied towards the April or May premium as the policyholder determines.
• Coverage must remain in force and claims must be paid and may not be pended.
• Read the full bulletin  here.

Cosmo Insurance Agency is an independent insurance agency serving surrounding communities in New Jersey. Cosmo keeps its promise to assure an efficient and creative approach to the services we offer. Each of our clients experience a personalized and long-term relationship with us. Our New Jersey based team of health brokers guides our clients in helping them choose the most cost-effective options. By incorporating the latest in technology-based tools and laws on healthcare, employee benefits, life insurance and finance, we keep our clients up-to-date with the plans that encompass all of their needs, whether it is individual or group insurance.

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