Health Republic Insurance of New Jersey: Letter to Members

i/m/o Freelancers Consumer Operated and Oriented Program of New Jersey
D/B/A Health Republic Insurance of New Jersey in Rehabilitation
570 Broad Street, Suite 1100, Newark, New Jersey 07102

October 31, 2016

Health Republic Insurance of New Jersey will not offer health insurance in New Jersey in 2017.

Here’s what is happening and what it means for you.

Important:  Your coverage under your employer’s group plan will terminate on December 31, 2016.  Your employer has been notified and may elect to provide coverage under a replacement group plan.  Immediately ask your employer if they will secure a replacement group plan.  If your employer will not be offering group coverage in 2017 you must act to select and enroll in an individual plan.  Enroll by December 15, 2016 if you enroll through the Marketplace (www.healthcare.gov ) or by December 31, 2016 if buying directly from an insurance company or through a broker, to secure replacement coverage that will be effective on January 1, 2017, to avoid any gaps in coverage. 

What’s happening?

Health Republic Insurance of New Jersey (Health Republic) is in hazardous financial condition and the Superior Court of New Jersey (Court) has declared the company insolvent.  The Court issued an Order of Rehabilitation which allows the New Jersey Department of Banking and Insurance (Department) to take control of the company.  The last day of your current Health Republic coverage through your employer is December 31, 2016.

Read this letter carefully and review all of your options.

What happens when coverage ends?
Your employer has been notified that the Health Republic group plan is ending on December 31, 2016, and has been given information about the steps to take to apply for a replacement group plan. 

Check with your employer to see if a replacement group plan will be in place by January 1, 2017.  If yes, you will want to look into enrolling under that new plan.  Ask your employer for plan information so you can decide whether the new plan will be a good option for you and your family. 

If your employer is not going to offer a new group plan in 2017, keep reading to understand your options for enrolling for coverage under an individual plan. 

Selecting an Individual Plan
Read this information if your employer is NOT offering a new group plan and you need to buy a plan on your own. 

When can you enroll for an individual plan for 2017?
The annual open enrollment period begins November 1, 2016 and runs until January 31, 2017.  Since your current coverage is ending you are eligible for a special enrollment period that will overlap with the annual open enrollment period and you can enroll in a different plan anytime between November 1, 2016 and March 1, 2017.

How to enroll to get a January 1 effective date
If you want to avoid a gap in coverage between when your Health Republic coverage ends on December 31, 2016 and the effective date of your new plan you need to pick up a new plan to be effective January 1, 2017.

If you enroll through the Marketplace (www.healthcare.gov) and want coverage to start January 1, 2017 make sure you enroll in an individual plan on the Marketplace no later than December 15, 2016.  If you wait beyond that date, you will have an effective date after January 1, 2017 and there will be a gap in your coverage. 

If you buy a new plan outside the Marketplace and want coverage to start January 1, 2017 you need to apply and pay your first premium no later than December 31, 2016.  Buying a new plan outside the Marketplace means you apply directly to an insurance company either on your own or with the assistance of an agent.

Effect of enrolling with an effective date after January 1, 2017

Since your Health Republic coverage ends December 31, 2016 enrolling with a later effective date will mean you will have a gap in coverage.  Any services or supplies you receive starting January 1 until the date your new plan is effective will not be covered. 

If you are enrolling through the Marketplace and enroll from the 1st to the 15th of the month, the effective date will be the first of the next month.  If you enroll from the 16th through the end of the month the effective date will be the first of the second month.  For example, if you enroll on January 5th, the effective date of the new plan will be February 1st.  If you enroll on January 25th, the effective date of the new plan will be March 1st.

If you are applying outside the Marketplace and apply as late as the end of the month the effective date will be the first of the next month.  For example, if you enroll on January 25th the effective date of the new plan will be February 1st.  Some insurance companies allow a 15th of the month effective date in addition to a 1st of the month effective date.  If this might interest you ask your selected insurance company if the 15th of the month effective date is available.

Here are the details about what you need to do if you need to purchase individual coverage because your employer is NOT offering a group plan in 2017.

1.  Decide whether to apply outside Marketplace or whether you want to enroll through the Marketplace.

You can look for a replacement plan with the assistance of an agent or by calling an insurance company directly.  The following website has information to assist you with shopping for insurance.  On the website you’ll find the names of all of the insurance companies selling individual plans as well as contact information.  http://www.state.nj.us/dobi/division_insurance/ihcseh/shop_ihc.htm

If your income is below 400% of the Federal Poverty Level it may be worth it to check with the Marketplace to see if you might qualify for tax credits and other cost savings.

2.  Choose a plan.

YOU HAVE THREE WAYS TO LOOK INTO NEW PLANS AND ENROLL:

  1. Visit healthcare.gov and look at Marketplace plans.
  2. Visit healthcare.gov and see if you qualify or your family qualifies for NJ FamilyCare
  3. Look at plans outside the Marketplace at:

http://www.state.nj.us/dobi/division_insurance/ihcseh/shop_ihc.htm

Just keep in mind that if you qualify for financial assistance to lower your monthly premiums or out-of-pocket costs, you can only get these savings if you enroll through the Marketplace.  If your income qualifies you for lower copayments, coinsurance, and deductibles you must enroll in a plan at the Silver level to take advantage of those lower amounts.

What if I can’t afford a Marketplace plan?
YOU CAN CONTACT THE MARKETPLACE AND APPLY FOR A HARDSHIP EXEMPTION.  This exemption will allow you to buy a catastrophic plan that usually has lower monthly premiums and will mainly protect you from very high medical costs.

When do I need to make a decision and act?
You can enroll in a new individual plan from November 1, 2016, through March 1, 2017. If you want a plan to be effective on January 1, 2017 so there isn’t a gap in your coverage, either:

  • apply by December 31, 2016 if you are buying outside the Marketplace, either directly from the insurance company or with the assistance of an agent; or
  • apply by December 15, 2016 if you are enrolling through the Marketplace (www.healthcare.gov).

Questions? Get in touch.

  • Visit Healthcare.gov, or call 1-800-318-2596 (TTY: 1-855-889-4325) to learn more about the Marketplace, to see if you qualify for lower costs, and enroll in a new plan
  • Find in-person help from an assister, agent, or broker in your community at Localhelp. Healthcare.gov.
  • Call Healthcare.gov at 1-800-318-2596 (TTY: 1-855-889-4325) to request a reasonable accommodation at no cost to you if you have a disability.
  • Visit http://www.state.nj.us/dobi/division_insurance/ihcseh/shop_ihc.htm

This notice is also available in alternative formats upon request and at no cost to persons with disabilities.

Getting help in other languages

Si usted necesita asistencia en Español por favor llame 888-990-5706.

Sincerely,

 

 

Health Republic Member Services team