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NJ Small Employer Health Benefits Program Buyer's Guide
Purpose of this Buyers' Guide

This Buyer’s Guide provides explanations of the basic rules governing the purchase of health coverage by small employers in New Jersey.  The Buyer’s Guide includes frequently asked questions along with responses to the questions. 

The Buyer’s Guide can help you determine if your business qualifies for coverage in the New Jersey small employer market.  For those businesses that qualify for small employer coverage the Buyer’s Guide and associated premium rates information offer some basic descriptions of the many coverage options that are available to small employers in New Jersey.

Please note:  The rules discussed in this Buyer’s Guide apply to the purchase of small employer coverage in the state-regulated small employer market.  For information regarding the federally-regulated Small Business Health Options Program (SHOP) visit

Laws Governing Small Employer Health Benefits Plans

Enacted in 1992, the New Jersey Small Employer Health Benefits Program Act (SEH Act) (N.J.S.A. 17B:27A-17 et seq) has provided significant protections to New Jersey small employers since 1994.  Through the years, the SEH Act has been amended by State laws as well as Federal laws.  Since 1996, standards regarding privacy and security of health information have been governed by the federal Health Insurance Portability and Accountability Act (HIPAA).  Various mandated requirements of the federal Patient Protection and Affordable Care Act (PPACA) became effective starting in 2010 with the most recent requirements becoming effective beginning in January 2014. 
Overview of Small Employer Health Benefits Program

As of January 2014, the Small Employer Health Benefits Program (SEH Program) defines a small employer as an employer with at least one but not more than 50 employees.  The rules for counting employees are explained in the Eligibility section of this Buyer’s Guide.  Generally, small employers must satisfy participation and contribution requirements.  Although there are two ways an employer can qualify as a small employer, some businesses will not be able to qualify as small employer and thus cannot buy SEH Program coverage.  Those businesses may purchase health coverage through the Individual Health Coverage Program.  See the IHC Program’s Buyer’s Guide for more information.
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