Frequently Asked Questions   >     New Jersey / Small Group Eligibility


New Jersey / Small Group Eligibility

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1. What is the definition of small employer ?

How is group size determined?

How does Guaranteed Renewability tie in?
2. Is the requirement that 51% of eligible employees work in NJ still in effect for 2014 under PPACA?
3. Who is eligible and not eligible to enroll in the Small Group ?
4. Who is an eligible spouse / dependent ?
5. Are Domestic Partners eligible ?
6. Are Civil Union partners eligible for health coverage ?
7. Are Domestic Partners and Civil Union partners eligible for Federal COBRA / NJ State Continuation ?
8. Explain the land mines with regards to Domestic Partners and Civil Union partners comparing NJ vs Federal law.
9. May a small employer provide coverage to an independent contractor (1099 employee) ?
10. May an employer vary any eligibility criteria by class of employee ?
11. Are union employees eligible to enroll?
12. Are retirees eligible ?
13. What is the minimum participation percentage ?
What is considered a legitimate waiver counting towards participation ?
14. Explain the question on the NJ Employer application that asks if the employer wants to cover Employees Only or Employees and Dependents.
15. What happens if a child is no longer a full time student ?
16. Can one person enroll ?   YES

How about owners only?   NO
17. What is a Pre-Existing condition ?
18. Does a Pre-Existing Condition Limitation Exclusion apply to any size group ?
19. What is a HIPAA "Special Enrollment" ?
20. Where can I obtain further information ?

Related Information

Please refer to the following documents for additional information:

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1. What is the definition of small employer ?

How is group size determined?

How does Guaranteed Renewability tie in?
You are not authorized to view this answer. To gain access to this content, Please click here.
2. Is the requirement that 51% of eligible employees work in NJ still in effect for 2014 under PPACA?
You are not authorized to view this answer. To gain access to this content, Please click here.
3. Who is eligible and not eligible to enroll in the Small Group ?
You are not authorized to view this answer. To gain access to this content, Please click here.
4. Who is an eligible spouse / dependent ?
You are not authorized to view this answer. To gain access to this content, Please click here.
5. Are Domestic Partners eligible ?
You are not authorized to view this answer. To gain access to this content, Please click here.
6. Are Civil Union partners eligible for health coverage ?
You are not authorized to view this answer. To gain access to this content, Please click here.
7. Are Domestic Partners and Civil Union partners eligible for Federal COBRA / NJ State Continuation ?
You are not authorized to view this answer. To gain access to this content, Please click here.
8. Explain the land mines with regards to Domestic Partners and Civil Union partners comparing NJ vs Federal law.
You are not authorized to view this answer. To gain access to this content, Please click here.
9. May a small employer provide coverage to an independent contractor (1099 employee) ?
You are not authorized to view this answer. To gain access to this content, Please click here.
10. May an employer vary any eligibility criteria by class of employee ?
You are not authorized to view this answer. To gain access to this content, Please click here.
11. Are union employees eligible to enroll?
You are not authorized to view this answer. To gain access to this content, Please click here.
12. Are retirees eligible ?
You are not authorized to view this answer. To gain access to this content, Please click here.
13. What is the minimum participation percentage ?
What is considered a legitimate waiver counting towards participation ?
You are not authorized to view this answer. To gain access to this content, Please click here.
14. Explain the question on the NJ Employer application that asks if the employer wants to cover Employees Only or Employees and Dependents.
You are not authorized to view this answer. To gain access to this content, Please click here.
15. What happens if a child is no longer a full time student ?
You are not authorized to view this answer. To gain access to this content, Please click here.
16. Can one person enroll ?   YES

How about owners only?   NO
You are not authorized to view this answer. To gain access to this content, Please click here.
17. What is a Pre-Existing condition ?
You are not authorized to view this answer. To gain access to this content, Please click here.
18. Does a Pre-Existing Condition Limitation Exclusion apply to any size group ?
You are not authorized to view this answer. To gain access to this content, Please click here.
19. What is a HIPAA "Special Enrollment" ?
You are not authorized to view this answer. To gain access to this content, Please click here.
20. Where can I obtain further information ?
You are not authorized to view this answer. To gain access to this content, Please click here.