On January 19, 2022, Gov. Murphy signed Executive Order No. 283 requiring covered workers at healthcare facilities and high-risk congregate settings to be up to date with their COVID-19 vaccinations, including having received booster shots when they are eligible. The new requirement was imposed to strengthen protections against the spread of COVID-19 and the Omicron variant to vulnerable populations across the state.

Examples of covered health and high-risk congregate settings covered facilities under the Order can be found at the NJ state’s press release site here. The covered workers include both full and part-time employees, contractors, and individuals providing operational, custodial, or administrative support.

Unvaccinated healthcare facilities’ covered workers subject to the Biden Administration’s vaccine mandate for healthcare settings had until January 27, 2022, to obtain their first dose of the primary series of a COVID-19 vaccination, and will have until February 28, 2022, to submit proof that they have completed their primary series and any booster shots for which they are eligible. For unvaccinated healthcare facilities’ covered workers who are not subject to the Biden Administration’s vaccine mandate for healthcare settings and high-risk congregate care, they will have until February 16, 2022, to obtain their first dose of the primary series of a COVID-19 vaccination and submit proof that they are up to date with their vaccination by March 30, 2022.

All covered workers will be required to be vaccinated by the dates set forth in the Order noted above and will no longer be permitted to submit to testing as an alternative to vaccination, except for employees who request and receive an exemption because of a disability, medical condition or sincerely held religious belief. If an employee receives an exemption, they must submit to weekly or bi-weekly testing in accordance with the previous Executive Order signed by the Gov. last year.

Employers with healthcare facility covered workers and high-risk congregate settings in the state should be aware of these new updates.

Executive Order 283 »

As a reminder, if an employer has at least one employee who resides primarily in New Jersey for at least 15 days in any month, the employer is subject to file Form(s) 1095 with the New Jersey Division of Taxation in the subsequent year annually. The current 2021 tax year’s filing is due on March 31, 2022. Employers are permitted to provide copies of Forms 1095-C (or B) that are prepared for the AIRS to meet NJ’s reporting requirements.

For fully insured plans, if their insurers are filing their NJ residents’ Form(s) 1095, then the employers are not required to file the forms with the state. Employers are encouraged to discuss and confirm with their insurers that the insurers are filing their forms timely.

For self-insured plans, employers are responsible for filing completed Forms 1095-C (or B) with the state, timely.

The main objective of this state reporting is for the state to enforce its Individual Mandate requirement by verifying that each resident had health coverage in the prior year.

Affected employers should be aware of these developments.

New Jersey Shared Responsibility Requirement Site »

The NJ Department of Labor and Workforce Development (LWD) recently announced that the 2022 Temporary Disability Insurance (TDI) employee contribution is 0.14% on the first $151,900 (wage cap) in covered wages earned during the calendar year. Accordingly, the maximum employee contribution for 2022 is $212.66/week. It is a significant rate decrease from the current rate of 0.47%. Employers are responsible for paying between $39.80 and $298.50 on the first $39,800 earned by each employee during this calendar year.

The 2022 employee contribution rate for Family Leave Insurance (FLI) is 0.14% on the first $151,900 (wage cap) in covered wages earned during the calendar year. The maximum employee contribution for 2022 FLI is $212.66 (the same as TDI). Employers are not required to contribute to the FLI program.

New Jersey employers should take note of the changes to these contributions and work with their payroll providers to institute the contributions.

Rate Information »
NJ TDI, Information for Workers, How the Program is Funded »
NJ TDI, Information for Employers, How the Program is Funded »
NJ FLI, How the Program is Funded »

On September 10, 2021 Commissioner Caride issued Bulletin No. 21-10 as a response to Tropical Storm Ida and the state of emergency declared by Gov. Murphy on September 1, 2021. The bulletin requires carriers to provide coverage of prescription drug refills even when the covered person has not yet reached the scheduled refill date. They must also permit coverage prescription drugs in excess of a 90-day supply. There must also be coverage through early refills and relaxed quantity limits with respect to lost or destroyed medications.

The Department of Banking and Insurance expects carriers to comply with and communicate the provisions of this bulletin to covered persons. Employers with New Jersey plans should be aware of this guidance.

Bulletin No. 21-10 »

On April 12, 2021, Commissioner Caride released Bulletin No. 21-07, extending the special enrollment period (SEP) on the state exchange as a part of New Jersey’s ongoing response to the COVID-19 pandemic and following the passage of the American Rescue Plan Act of 2021. The SEP will now be in effect through November 30, 2021. As background, individuals may usually only elect coverage through the state exchange (Get Covered New Jersey) during open enrollment or special enrollment periods.

During this SEP, individuals who are not already enrolled in an individual health benefits plan can apply for coverage through the exchange or directly through carriers. The SEP will also allow individuals who are already enrolled in a health benefits plan to replace their coverage with coverage on the exchange. The coverage will be effective no later than the first of the next month after an individual’s enrollment.

Although this change affects the individual market, employers should keep this in mind as it would likely create a qualifying event that would allow for an employee to potentially drop employer coverage (for themselves or their dependents) to go on the New Jersey exchange.

Bulletin No. 21-07 »

On January 29, 2021, Commissioner Caride released Bulletin No. 21-03, providing a special enrollment period (SEP) on the state exchange as a part of New Jersey’s ongoing response to the COVID-19 pandemic. The SEP will be in effect from February 1, 2021, through May 15, 2021. Individuals may only elect coverage through the state exchange (Get Covered New Jersey) during open enrollment or special enrollment periods.

During this SEP, individuals who are not already enrolled in an individual health benefits plan can apply for coverage through the exchange or directly through carriers. The SEP will also allow individuals who are already enrolled in a health benefits plan to replace their coverage with coverage on the exchange. The coverage will be effective no later than the first of the next month after an individual’s enrollment.

Although this change affects the individual market, employers should keep this in mind as it would likely create a qualifying event that would allow for an employee to potentially drop employer coverage (for themselves or their dependents) to go on the New Jersey exchange.

Bulletin No. 21-03 »

On January 7, 2021, Commissioner Caride issued Bulletin No. 21-01, which provides guidance to health insurers on preventive health services, including COVID-19 immunizations. The bulletin prohibits carriers – including those administering self-funded plans – from charging any cost sharing for qualifying coronavirus preventive services delivered in-network or out-of-network. Additionally, the Department of Banking and Insurance expects carriers to assess their readiness and take all steps to ensure that insureds have access to COVID-19 immunizations and their administration. When vaccines require multiple doses, carriers should communicate to insureds that they need to get both doses of the same vaccine. Carriers should also provide information to providers on how to submit claims for reimbursement of the immunizations.

Although this bulletin is directed towards insurance carriers, employers based in New Jersey should familiarize themselves with this guidance as individuals begin to access COVID-19 immunizations.

Bulletin No. 21-01 »

On July 31, 2020, Gov. Murphy signed Assembly Bill No. 4389 into law. The bill imposes an annual 2.5% state tax on the premiums collected by most health insurers. As background, the ACA imposed a tax on health insurers (known as the HIT tax) that has been repealed and will no longer be levied in 2021. This NJ tax will essentially take the place of that federal tax.

Specifically, the tax would be levied on insurers and the funds would be passed on to a health insurance affordability fund that will be designed to subsidize premiums for low-income individuals and to bolster the state’s reinsurance pool. The bill also seeks to reduce racial disparities in coverage for the uninsured. To those ends, the bill also requires a report examining how the policy increases affordable healthcare options, reduces the uninsured rate and affects racial disparities in health insurance coverage.

While the law applies to insurers, it’s widely expected that insurers will pass this additional tax to consumers through health plan premiums. The tax is set to become effective in January 2021. We will continue to follow any developments with this law.

Assembly Bill, No. 4389 »

On March 16, 2020, the Department of Labor & Workforce Development released guidance on how the state’s earned sick leave, temporary disability insurance (TDI), and family leave insurance laws apply in regards to the coronavirus emergency. The FAQs provide details on when employees may use their earned sick leave or family leave for purposes of COVID-19-related leave.

For example, if an individual or their loved one has tested positive for COVID-19, has symptoms, has been exposed to it through their work, or has been advised by a healthcare provider or public health authority to quarantine, they may use earned sick leave, but can only apply for TDI after exhausting unemployment benefits. Additionally, if employees have children that are home from school because the school is shut down for cleaning or decontamination or if the person’s business is ordered closed due to a public health reason, then they may be able to take leave under the earned sick leave law.

Employers should review this guidance in order to properly communicate with employees regarding the potential for leave or benefits under New Jersey law.

Worker Benefits, Protections and the Coronavirus (COVID-19): What NJ Workers Should Know »

On May 28, 2020, Commissioner Caride released Bulletin No. 20-27, requiring insurers to provide a 60-day grace period for the payment of health and accident policies. The bulletin directs insurers to extend an emergency grace period for the payment of premiums to their policyholders pursuant to the governor’s emergency declaration. Policyholders may elect to begin the emergency grace period retroactively on April 1, 2020, or May 1, 2020, and during the 60-day period, coverage must remain in force and claims must be paid and not pended. Additionally, after the grace period ends, the policyholder must be given the option to repay the missed premiums over the remaining months of the policy (but for not less than six months).

Although this guidance is directed at insurers, employers with policies based on New Jersey would be able to avail themselves of this relief if needed.

Bulletin No. 20-27 »