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Home > Division of Insurance > New Jersey Proposal for ACA Section 1332 State Innovation Waiver
New Jersey's ACA Section 1332 State Innovation Waiver
 
2024 Annual Public Forum   2023 Extension Information   Reports
 
Background/Introduction

Senate Bill No. 1878, the “New Jersey Health Insurance Premium Security Act,” was signed into law on May 30, 2018 and is codified at N.J.S.A.17B:27A-10.1 et seq. This law contemplates the creation of a reinsurance plan to reimburse carriers for certain high-cost claims in the individual health insurance market. The law provides that the reinsurance plan would use a mix of federal and state funds to produce individual health insurance premiums that are 10% to 20% lower than they would be without the plan. Under the law, the reinsurance program will reimburse individual health carriers for a proportion (coinsurance amount) of the cost of certain high-cost claimants between a minimum lower bound (attachment point) and a maximum upper bound (cap).

Senate Bill No. 1878, which authorized the Commissioner of the Department of Banking and Insurance to apply for a 1332 Innovation Waiver to implement the bill, may be found here: www.njleg.state.nj.us/2018/Bills/AL18/24_.PDF

Pursuant to this law, the Department submitted a waiver application targeting a 15% premium reduction in the individual market and seeking federal funding to help achieve this target.  The waiver application was approved by the Centers for Medicare and Medicaid Services on August 16, 2018.

Waiver Application information
2024 Annual Public Forum
 
Notice of Annual Public Forum to be held December 20, 2024

The New Jersey Department of Banking and Insurance (Department) will hold a Public Forum regarding New Jersey’s 1332 Innovation Waiver which was used to create the reinsurance program for the New Jersey individual market. 


Public Forum Date: December 20, 2024  2 PM


The Public Forum will be held in Room 220, at 20 West State Street, Trenton, NJ.

To request reasonable accommodations, please contact Michael Fahncke at Michael.Fahncke@dobi.nj.gov by December 19, 2024 in order to ensure your request is processed.


Members of the public may listen to the forum using the following dial-in information:

Dial-in: 1-888-363-4734
Access Code: 3545220#

Background

As provided in P.L. 2018, c.24, the New Jersey Health Insurance Premium Security Act, the Commissioner applied for and received approval for federal funds through a 1332 Innovation Waiver which supported the creation of a reinsurance program.  With the reinsurance program, carriers selling plans in the individual market request reimbursement for reinsurance-eligible claims and, as a result, were able to reduce individual health insurance rates.  As a result of the reinsurance program, 2023 individual health insurance premiums were 15 percent lower than they would have been without reinsurance. The first five years of operation for the reinsurance program were 2019, 2020, 2021, 2022 and 2023. This 2024 Forum is being held following completion of all requirements for the 2023 plan year.

The majority of the funding of reimbursement requests under the reinsurance program comes from federal funds made available through the 1332 Innovation Waiver. For plan year 2023, such federal funding was $375,257,388.  The balance of the necessary funding comes from revenue raised by the “New Jersey Health Insurance Market Preservation Act,” and the Health Insurance Affordability Fund.


Reports


 
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