TRENTON — New Jersey Department of Banking and Insurance Acting Commissioner Justin Zimmerman today announced a total of $5 million in available grant funds for community organizations to apply to serve as state-certified Navigators for the Get Covered New Jersey Open Enrollment Period and throughout 2025. Navigators offer free, unbiased, community-based education and assistance to consumers seeking to enroll in health insurance through Get Covered New Jersey, the state’s Official Health Insurance Marketplace.
“The Murphy Administration is committed to increasing access to quality, affordable health insurance and investment in local outreach is part of that effort,” said Department of Banking and Insurance Acting Commissioner Zimmerman. “Local organizations serve a vital role in engaging and supporting New Jerseyans across the state in their own communities. Navigators provide a valuable service in helping residents obtain financial help available through Get Covered New Jersey and one-on-one assistance to connect them to the health coverage they deserve.”
Navigator outreach efforts include public information events and activities meant to connect and educate consumers about their health coverage options and the record levels of financial assistance that remain available. Consumers may access Navigator assistance in person or remotely throughout the state.
The Murphy Administration has significantly increased its investment in Navigators since the State began operating the Navigator program in 2019 and has taken numerous actions to improve access to health coverage. Last year, the department invested $5 million in 26 Navigators—up from $400,000 for just one Navigator under the federal government in 2019. The state began operating as a State-Based Marketplace on November 1, 2020 under a law (P.L. 2019 c. 141) signed by Governor Phil Murphy and, in addition to federal tax credits available through the federal Affordable Care Act, began offering state-level subsidies to further lower health plan costs.
During the most recent Open Enrollment Period, a total of 397,942 residents signed up for health insurance at Get Covered New Jersey— a record high and 61 percent increase since the Murphy Administration took over operations of the marketplace in 2020 for plan year 2021. The average amount of financial help received for 2024 coverage is $566 per person per month, or $6,792 per person per year, as a result of federal and state savings. Nine out of 10 residents enrolling at Get Covered New Jersey qualify for financial help and many individuals receiving financial help have access to a health plan at a cost of $10 a month or less.
Federal savings available through the Inflation Reduction Act also allowed New Jersey to increase the amount of state subsidies, called New Jersey Health Plan Savings, available to eligible consumers and to extend the state savings to residents at higher income levels—those with an annual household income of up to 600 percent of the federal poverty level ($81,540 for an individual and $166,500 for a family of four in 2023).
All Marketplace programs are required to operate and fund a Navigator program. To be eligible for funding through the grant program, organizations must demonstrate that they comply with the regulatory requirements outlined by the U.S. Centers for Medicare and Medicaid Services (CMS) and the department’s requirements in the Request for Applications. Current Navigators and organizations seeking to become Navigators will have the opportunity to apply for funding to serve for the 2024-2025 year to support enrollment assistance.
All assisters—inclusive of Navigators, Certified Application Counselors, and Brokers—will be required to complete state training and certification to assist consumers with health insurance enrollment on the state Marketplace. The $5 million grant program will be funded by the user fees that support the department’s operation of the State-Based Marketplace.
Grantee activities will include outreach and education year-round for 2025 coverage, including in advance of and during the Open Enrollment Period that will run from November 1, 2024 until January 31, 2025. Navigators also assist consumers who are eligible to enroll in coverage outside of Open Enrollment, through Special Enrollment Periods throughout the year.
Open Enrollment is the only time of year residents can enroll in a plan through Get Covered New Jersey, unless they have a major life event, such as getting married, moving, having a baby, pregnancy, losing NJ FamilyCare coverage (Medicaid/CHIP), losing employer-sponsored coverage, or if they meet certain income standards that qualify them for a Special Enrollment Period.
Among other requirements, organizations applying for funding must demonstrate established credibility and experience in the areas of health or social services, specifically in supporting consumers with income-based applications for government programs, navigating the complexities of the health care system, health insurance education and enrollment support, consumer or patient advocacy, or other activities where the entity has advocated on behalf of or directly assisted and educated consumers seeking support in getting access to coverage or health care services.
A Request for Applications (nj.gov/dobi/financial/) for funding for the New Jersey State Navigator Program was released today. Organizations have until September 25, 2024 to apply. |
