New Jersey Individual Mandates ACA Reporting Requirements
ACA Reporting Requirements under New Jersey Individual Mandate- An Overview- Updated November 06, 2020 - 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.
The penalty for failing to comply with the ACA’s shared responsibility provision (individual mandate) throughout the 2020 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.
Employer Responsibility for New Jersey Individual Mandate
Employers who provide a “Minimum Essential Coverage” to N.J. residents must electronically file their ACA reporting forms ( coverage information) to the State of New Jersey through the MFT Secure transport service.
These employers must also distribute copies of their ACA reporting forms 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.
What Form To File?
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 forms 1095-B / 1095-C electronically through the State’s
system for filing W-2 forms and furnish copies to each primary enrollees 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 New Jersey State?
The deadline to distribute copies of form 1095-B/C to employees:
March 02, 2021 - Employers must distribute written statements (Form 1095-B/C) to the primary enrollees
(N.J. residents) on their plans before the deadline.
The deadline to file the ACA reporting form to the State:
March 31, 2021 - 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.
Note: Paper filings will not be accepted.
What Information Must be Reported?
- 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 New Jersey?
As of the publication of this article, 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.
ACAwise takes care of State Individual health care mandates reporting.
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 the forms 1094 & 1095 and e-file it with the IRS and State. We also handle the postal mailing of your form 1095 copies to your employees before the recipient copy deadline.