What New Jersey employers need to know about Forms 1095 & 1094 requirements

Call this a case of “the more things change, the more they stay the same.”

When the Affordable Care Act’s Individual Mandate provision was reduced to $0 on Jan. 1, 2019, most viewed it as the end of the mandate.

New Jersey, along with Washington, D.C. and other states, saw it as an opportunity to create its own replacement.

In enacting its own mandate to begin in 2019, New Jersey sought to ward against adverse selection concerns that could stem from the federal repeal. It also gives employers a powerful piece of legislation they need to keep top of mind in their compliance strategies. As New Jersey makes adjustments to its own mandate, the challenge of keeping up with the changes can be difficult.

In many ways the New Jersey mandate closely resembles the Federal Individual Mandate it was designed to replace.

Beginning in 2019, New Jersey residents are required to secure health insurance or pay a fine of either 2.5 percent of their household income or $695 per adult and $347.50 per child, whichever is greater. The maximum household penalty will be $2,085.

The state expects to collect between $90 million and $100 million in penalties. That money will fund the New Jersey Health Insurance Premium Security Fund which help pay the claims of people who are catastrophically ill, providing stabilization to the pool of covered people with catastrophic claims so their medical premium rates do not rise dramatically.

What do employers need to do?
Just as was necessary with the federal mandate, New Jersey’s mandate will also require employers with employees or COBRA participants who have resided in the state at any time over the past year to provide information on insurance coverage. This includes the submission of Forms 1094 and 1095 for New Jersey residents, in addition to the standard IRS filing.

Out-of-State Employers of New Jersey Residents: Out-of-state employers with New Jersey residents have the same filing requirements as businesses located in New Jersey.

Similar to the Federal reporting timeline, New Jersey requires 1095 forms to be delivered to employees by the due date of Jan. 31, 2020. The Forms 1095 and 1094,  including applicable New Jersey resident information, must be submitted to the state by March 31, 2020.

Finding help for your company and keeping up with constant legislative changes
If your company has employees or COBRA participants who reside in New Jersey the challenge of maintaining your compliance with healthcare mandates has changed and it can be confusing.

We can help.

At Health e(fx) we offer a leading compliance, analytics and workforce solution to help you track your compliance considerations and coverage options no matter where you do business or which ways the laws change.  We make it easy by providing a combined Federal and State reporting solution.

For 2019 New Jersey reporting, we offer:

  • State configuration and setup
  • Employee filing message on all forms
  • Form audit and approval
  • Employer filing and submission
  • Corrections process
  • State ledger reports (Form 1095-B/C)

We will offer a similar product to help employers meet 2019 Washington, D.C. Reporting requirements. Contact us today to learn more about how our solutions can support your company, and stay tuned to our legislative updates to see how government policy change can impact your company.