New Jersey’s Section 1332 Draft Waiver Application, which was updated during the public comment period, can be found here:

New Jersey's Section 1332 Final Waiver Application, submitted July 2, 2018, can be found here:

The final application is also available from the Department of Banking and Insurance by email request to: 1332WaiverApplication@dobi.nj.gov.

New Jersey received notification from the Centers for Medicare and Medicaid Services, dated August 16, 2018, that the federal government approved New Jersey's State Innovation Waiver Application.

In compliance with Federal regulations, the Department of Banking and Insurance held two public hearings on New Jersey’s 1332 Innovation Waiver Application.

The New Jersey Department of Banking and Insurance (Department), in conjunction with the New Jersey Individual Health Coverage Program Board (IHC Board), held a Post Award Forum regarding New Jersey’s 1332 Innovation Waiver.

P.L. 2018, c.24, the New Jersey Health Insurance Premium Security Act (Act), directed the Commissioner of the Department to apply to the United States Secretary of Health and Human Services for a waiver of applicable provisions of the Affordable Care Act with respect to health insurance coverage in the State for a plan year beginning on or after January 1, 2019.  The Department applied for and received approval for federal funds for a reinsurance program through a 1332 Innovation Waiver.  Through the creation of a reinsurance program, carriers selling plans in the individual market may request reimbursement for certain high-cost claims and, as a result, lower individual health insurance rates. 2019 was the first year of operation for the reinsurance program. 

To be eligible for reimbursement for plan year 2019 and 2020, claims must satisfy the following payment parameters:  $40,000 attachment point/ 60% coinsurance/ $215,000 cap. For plan year 2021 and 2022, the payment parameters are: $35,000 attachment point/ 50% coinsurance/ $245,000.00 cap. The result for New Jersey consumers is individual health insurance premiums that are 15% lower than they would be without the reinsurance plan.

The majority of the funding of reimbursement requests under the reinsurance program will be federal funds made available through the 1332 Innovation Waiver. The balance of any necessary funding will come from revenue raised by the “New Jersey Health Insurance Market Preservation Act,” and, if necessary, the General Fund.

For plan year 2019, the State received $180,201,687 in federal funding for the program. The total cost of the program was $267,724,523.38. For plan year 2020, the state received $190,015,727.  Federal funding for plan year 2021 has not been finalized.

Since the program began operating in 2019, annual public forums have been held to comply with federal requirements.  The first annual public forum was held virtually on June 10, 2020. 

• 2023 Public Forum Presentation (PDF)