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NJ Department of Banking and Insurance

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Obtaining Coverage
NJ Individual Health Coverage Program Buyer's Guide

To obtain coverage, we suggest you follow these steps:

1. Review this Buyer’s Guide to learn more about individual health coverage in New Jersey, the plans available, and the benefits they provide.
2. Review the list of participating carriers and compare rates. Then contact the carriers to get more information, or contact a licensed insurance producer (also called an agent or broker), who can help you make an informed decision, at no additional cost to you. (Some carriers do not use insurance producers.)
3. Review the carriers' materials and select the carrier and individual plan that best meets your needs.
4. Complete the carrier's application form. All carriers use a standard application form (sometimes called the HINT form) so the application from one carrier should look very much like the application from another carrier.
5. Send your completed application to the carrier. If your coverage will take effect within the next month, you must include the first premium payment with your application.  Some carriers may allow you to authorize the carrier to deduct the premium payments from your checking account before the effective date.  Check with the carrier you are selecting to find out if this is an available option.

Coverage applied for by December 31 during the Annual Open Enrollment Period does not take effect until the following January 1, so the payment of the first premium either by check, or pre-authorized checking account deduction, may be delayed until December.

Upon receiving your application and premium payment, your carrier will send you an ID card and a policy or contract that indicates the effective date of your coverage. Your effective date of coverage usually depends on the date your completed application materials and premium payment are received. Be sure to check the enrollment materials for your effective date of coverage. If the ID card is not provided prior to the effective date of coverage, the carrier may suggest that you use a copy of your application as evidence of coverage. 

You cannot be covered under two individual plans at the same time. If you decide to change your individual coverage, and you purchase coverage from another carrier, the carrier that issued your old plan must be notified that you want to terminate the old plan.  If the carrier that issued the old plan is notified within 30 days after the new coverage takes effect, the carrier will retroactively terminate the old plan as of the day before the new coverage takes effect. 

Generally, you cannot be covered under both an individual plan and a group plan.  If you are currently covered under a group plan and are applying for an individual plan you must terminate the current group coverage no later than the day before the individual plan will take effect. 

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New Jersey Department of Banking and Insurance