New Jersey ACA Form 1095-B/C Reporting Requirements
New Jersey State Individual Mandate ACA Reporting - An Overview- Updated August 29, 2023 - 8.00 AM by Admin, ACAwise
After eliminating federal individual mandates under the Affordable Care Act (ACA) by Congress, the New Jersey Health Insurance Market Preservation Act (“individual mandate”) went into effect on January 1, 2019.
This requires every New Jersey resident to obtain “Minimum Essential Coverage” for each month of the calendar year, have a valid exemption, or make a
Shared Responsibility Payment (SRP) on their
N.J. tax returns.
Minimum Essential Coverage (MEC) under the mandate has the same definition as that under the Affordable Care Act, which requires each N.J. resident to maintain coverage that includes ten categories of essential health benefits and services to avoid
facing a penalty.
These instructions will help employers better understand their New Jersey ACA Reporting Requirements.
Employer Responsibility for New Jersey State Individual Healthcare Mandates
After New Jersey passed its own individual mandate, the state requires New Jersey employers or out-of-State employers to provide the Minimum Essential Coverage to the employees and their dependents residing in the state.
Employers who provide Minimum Essential Coverage to NJ residents must report the health coverage information to the state, indicating that they meet Minimum Creditable Coverage (MCC).
These employers must report coverage offered to each primary enrollee who was a full-year New Jersey resident or part-year New Jersey resident. A part-year New Jersey resident is a primary enrollee who lived in New Jersey for at least 15 days in a month.
How to Report to the State of New Jersey?
New Jersey employers or out-of-State employers who provide MEC to N.J. residents must file the same information found in the 1095-B/C Federal Forms to the State and distribute the copies of the 1095 form to each primary enrollee.
- For Employers offering fully insured plans, most insurance carriers will submit Form 1095-B / 1095-C electronically through the
State’s system for filing W-2 Forms and furnishing copies to each primary enrollee on behalf of these employers. If their insurance carrier fails to do this, employers are responsible for fulfilling these obligations to avoid facing penalties.
- For employers with self-insured plans, the employer is responsible for filing Forms 1095-B / 1095-C to the State electronically through the State’s system to file W-2 Forms and distribute the written statements to each of their covered primary enrollee (N.J. residents).
When to File ACA Form 1095-B/C with the New Jersey State?
The deadline to distribute copies of form 1095-B/C to employees:
March 04, 2024 - Employers must distribute written statements (Form 1095-B/C) to the primary enrollees
We prepare forms, e-file it with State, and distribute employee copies.Request Quote
The deadline to file the ACA reporting form to the State:
April 01, 2024 - Employers are required to file employee’s information returns (1095-B/C) electronically to the State of New Jersey using the Division of Revenue and Enterprise Services' (DORES) MFT Secure Transport service on or before the deadline.
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Note: Paper filings will not be accepted.
Required Information for New Jersey ACA Form 1095 Reporting
- 1. Name, address, and SSN/TIN of the covered individual.
- 2.Name, address, EIN, and contact info of the plan provider.
- 3.For self-insured group health plans: name, address, EIN, and contact information of the plan sponsor.
- 4.The offer of coverage code for each recipient/employee, broken down by month.
- 5.The recipient/employee’s premium share of coverage, by month.
- 6.Any safe harbor relief codes that are applicable
- 7.The covered individual's spouse and dependent(s) information, if applicable (name, SSN or DOB, and months covered)
What are the Penalties for Failure to File Form 1095 with the New Jersey
The penalty for failing to comply with the ACA’s shared responsibility provision (individual mandate) throughout the tax year is calculated at a rate of $695 per taxpayer or 2.5% of gross income for people above the New Jersey tax filing threshold, whichever is higher.
For failure to file ACA Forms 1095-B/C, it is unclear whether there are any penalties for employers who fail to fulfill these obligations. Once the State establishes this information, we will provide an update accordingly.
Meet your New Jersey ACA Reporting with ACAwise
With extensive experience in handling the e-filing of both the federal ACA reporting and the State individual mandate reporting, ACAwise can accurately and quickly report your healthcare coverage information to the State electronically through the State’s system for filing W-2 forms without any additional stress.
Send us your employee’s payroll, benefits, and census data through an excel template or use our own template. We will generate and e-file forms 1094 & 1095 with the IRS and State. We also handle the distribution of your form 1095 copies to your New Jersey employees before the recipient copy deadline.
Get Started with ACAwise to simplify your New Jersey State Mandate ACA reporting.