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 29, 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: Take action by December 15, 2016 or you’ll be automatically enrolled in a new Marketplace plan. If you do not pay the required premium for this new plan or select another by March 1, 2017, you will not have health insurance for 2017.


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 is December 31, 2016.

Read this letter carefully and review all of your options.

When can you enroll in a new plan for 2017?
The annual open enrollment period begins November 1, 2016 and runs until January 31, 2017.  Since your current plan 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 plan 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 for a new plan on the Marketplace no later than December 15, 2016.  If you wait beyond that date you will be assigned an effective date that is after January 1, 2017. 

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.

Since your Health Republic plan will not be available in 2017, the Marketplace will recommend another plan that may meet your needs, and will send you information about this suggested plan directly. If you do not take any action by December 15, 2016, you’ll automatically be enrolled in this plan.  So if you pay the premium for this new plan you won’t have a gap in coverage.  Of course, if you do not like the recommended plan you do not have to pay the premium and you can select another plan.  But, if you are enrolling through the Marketplace the new plan you elect after December 15, 2016 will not be effective on January 1, 2017, and you will have a gap in coverage.

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

Since your Health Republic plan 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.

1.  Update your Marketplace application by December 15, 2016.

It is important to review your Marketplace application on healthcare.gov by December 15, 2016 to make sure the information is still current and correct, and to see if you may qualify for more or less financial help in 2017 than you’re getting now. This may result in a lower monthly premium payment or lower out-of-pocket costs. Plus, it could help you avoid paying money back when you file your taxes.

If you didn’t receive advance payments of the premium tax credit in 2016, tax credits and other cost savings are available to most people who have a Marketplace plan. Even if you didn’t get these savings last year, it’s worth checking to see if you qualify this year.

Note: If you got financial help in 2016 to lower your monthly premium, you’ll have to “reconcile” when you file your federal taxes. This means you’ll compare the amount of premium tax credit you used in advance during 2016 with the amount you actually qualify for based on your final 2016 household income and eligibility information. If the numbers are different, you may get more or less tax refund, or you may owe money back.

2.  Decide if you want to enroll in the suggested plan or choose another one.

So What Are My Options If . . .

  • I like the suggested plan?
    • YOU DON’T HAVE TO DO ANYTHING. You’ll automatically be enrolled and just have to pay the monthly premium.
  • I don’t like the suggested plan?
    • YOU HAVE THREE WAYS TO LOOK INTO OTHER PLANS AND ENROLL:
  1. Visit healthcare.gov and look at other Marketplace plans.
  2. Visit healthcare.gov and see if you qualify or your family qualifies for NJ FamilyCare
  3. Look at other 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.

  • 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 plan from November 1, 2016, through March 1, 2017. If you want a plan other than the recommended plan, enroll in a new plan by December 15, 2016, to make sure there isn’t a gap in your coverage.

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