New Jersey Health Insurance


New Jersey Company Health Insurance Rules

Are there any laws concerning who companies do and do not have to give health benefits to? Do the companies set the number of hours needed to receive benefits? I work for a company with over 300 employees, but I am not eligible for their health benefi...
by Tracy in New Jersey, 03/01/2006

New Jersey Health Insurance

New Jersey has strict health insurance regulations, which is quite beneficial to you. However, to make these rules work for you, you need to know what they are. Before we start, though, you should know that in order to be eligible to purchase an individual New Jersey health insurance policy, you cannot qualify to receive similar coverage under a group health plan.

This guide:

  • Describes New Jersey health insurance policy regulations.

  • Lists rules New Jersey health insurance companies must follow.

Health insurance policies are regulated by each state's own health insurance laws. New Jersey health insurance companies and policyholders alike must abide by established insurance laws.

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You can pick what coverage you want and set your limits and deductibles, before applying for more personalized rate info. This is a service that will provide you with competing quotes from local agents who can also offer help with setting coverage limits, deciding on a plan, etc.

New Jersey health insurance policy provisions

Some of the most important New Jersey health insurance laws are the ones that influence the health insurance policy specifically. New Jersey in unlike most states in that you have six standardized New Jersey health insurance policies from which you can choose.

Health insurance policies that aren't one of these standardized plans still must follow New Jersey's health insurance regulations. For instance, a guaranteed renewability provision is included in every policy issued in New Jersey. This provision states that, as long as premiums have been met, your New Jersey health insurance company cannot deny you continued coverage.

Also, New Jersey health insurance policies can contain a provision excluding a medical condition from your health insurance coverage for a period of 12 months if they are considered ?pre-existing? conditions. State laws define the term ?pre-existing? differently.

In New Jersey, conditions are considered to be pre-existing if you received medical treatment for or were diagnosed with them 6 months prior to the beginning of the plan. Legally, New Jersey health insurance companies are allowed to include exclusion periods for any condition that falls under this description.

If you switch New Jersey health insurance companies, you can avoid having a second exclusion period imposed by making sure your health insurance coverage is continuous. If you have no break in between policies, your old coverage credits your new plan's exclusion period.

Regulating New Jersey health insurance companies

The other area of importance in regards to New Jersey health insurance laws is the degree of influence your health insurance company has over your policy and its price.

Although most New Jersey health insurance companies can deny your application for health insurance, Blue Cross Blue Shield is required to offer health insurance to every resident.

However, New Jersey health insurance companies cannot deny you health insurance due to your health status, age or any other factor. Additionally, the cost of your Hew Jersey health insurance premiums cannot be dependent upon your health, occupation, age, or gender, although they can vary with family size.

Finally, New Jersey health insurance companies must renew your policy upon your request unless you have violated a par of the contract,

More NJ health insurance help

If you want more help getting the a good health insurance policy, read our guide to health insurance.

Also see the guide to New Jersey small business health insurance.

To find out more about NJ health insurance laws and regulations, visit the official website of the New Jersey Department of Banking and Insurance.