New Jersey ACA Filing Requirements – TY 2021

Many states have adopted Individual Mandates. New Jersey ACA filing is now required for certain employers and insurance providers.

Clarifications to New Jersey ACA Requirements

The NJ Market Preservation Act requires reporting to verify coverage provided by payers of NJ’s Income Tax.

NJ requires employers, insurers, and other coverage providers to:

  • Transmit 1095 health coverage forms to the NJ Division of Taxation by 03/31/21.
  • Provide 1095-C form to each primary enrollee who was a part or full year NJ resident and whom the filer provided Minimum Essential Coverage (MEC)
  • Must ensure that NJ receives the appropriate 1095-C forms. NJ expects to accept new forms NJ-1095 and fully completed forms 1095-B or forms 1095-C and/or forms 1095-C with Parts I and III completed.

Where New Jersey ACA Requirements Differ From Federal Requirements

Forms 1095-C with only Parts I and II completed will not meet New Jersey ACA requirements. These should only be transmitted to the state if they are part of a larger file that includes other required forms that do meet New Jersey ACA filing requirements.

The state tentatively plans to accept the federally required forms 1095, but cannot verify definitively until the IRS posts the finalized forms. If they do not meet New Jersey ACA needs, then the NJ Division of Taxation expects to use only the NJ-1095 after updating it from its 2019 version.

Each primary enrollee who was a NJ resident in 2021 should receive at least one form 1095 that includes health coverage information by the deadline of 03/02/21.

Where New Jersey Form 1095-B Requirements differ from Federal Requirements

New Jersey ACA requirements state that a 1095 form be sent to each primary enrollee. This differs from federal requirements that allow some coverage providers to notify primary enrollees that a form is available upon request.

The requirement to file is for all employers, including out of state employers, who provide health coverage to NJ residents they employ.

Insurers, government agencies, and all others responsible for reporting MEC on behalf of NJ residents must file the required information to the state.

Out-of-State Employers

What forms are required from whom?

  • 1094 forms are not required but are accepted if sent with 1095 forms.
  • NJ will accept NJ-1095 from any filer.
  • Federal 1095-C forms will be accepted if, minimum, Parts I and III are fully completed.
  • NJ will accept fully completed 1095-B forms.

Insurers must file for coverage obtained on NJ’s state health insurance exchange, and send forms to each primary enrollee.

Guidance on forms sent to New Jersey

Those who file more than 100 forms 1095 can send files that only include NJ residents, although files will be accepted that include data about non-NJ residents. Please note: filers who provide information on non-NJ residents should consult privacy and other laws pertaining to the states in which the non-NJ residents reside before sending any personal or sensitive data about non-residents.

Requirements vary depending on type of insurance offered:

Fully Insured

  • ALE, Single Company:
    • Typically, insurers file the 1095 for each covered member of the plan, but if an insurer does not meet this obligation, then the employer is required to fulfill it.
      • A fully completed 1095-B or NJ-1095 will meet NJ requirements.
    • Non-ALE, single company:
      • Typically, insurers file a 1095-B or NJ-1095 for each covered member of the plan, but if an insurer does not meet this obligation, then the employer is required to fulfill it.
    • Fully insured in Multi-employer plan:
      • A plan sponsor typically files 1095-B or NJ-1095 forms for enrolled individuals, but if the plan sponsor does not meet this obligation, then the employer is required to fulfill it.

Self-Insured

  • ALE, single company:
    • Employers file a fully completed 1095-C, 1095-B, or NJ-1095 for each person who was a full time employee for at least one month of the year and for any employee who was enrolled in coverage.
    • Non-ALE, single company:
      • These employers file a 1095-B or NJ-1095 for each covered employee.
    • Self-Insured Employers in Multi employer plan:
      • A plan sponsor typically files a 1095-B or NJ-1095 for each covered employee, but if the plan sponsor does not meet this obligation, then the employer is required to fulfill it.

Other Considerations

  • There is no paper filing option available for the state of NJ.
  • If you are an employer of a New Jersey resident, or if you provide Minimum Essential Coverage to a New Jersey resident, you must e-file your ACA data.

Conclusion

Employers must keep these ACA state requirements in mind when completing their filings. It’s imperative that employers ensure that these state requirements and federal requirements are met prior to each applicable deadline.

Once you have submitted your ACA filings federally and to the applicable states, have received an “accepted” status, and have furnished employee copies, then it sounds like you have fulfilled all of your ACA requirements.

If you’re looking for more information on ACA Summary Forms 1094-B and 1094-B to determine which type you need to file, download our Understanding ACA Summary Forms Guide here:

BoomTax, The Boom Post, and its affiliates do not provide tax, legal or accounting advice. This material has been prepared for informational purposes only, and is not intended to provide, and should not be relied on for, tax, legal or accounting advice. You should consult your own tax, legal and accounting advisors prior to engaging in any transaction.

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