New Jersey Group Health Insurance & Employee Benefit Plans

For over 25 years, Taylor Benefits has provided satisfied clients with group health insurance plans to fit their needs. Each plan is custom-designed to best benefit each client. Since Taylor Benefits works with all major insurers in NJ, we craft a health plan that meets your needs instead of trying to fit you into a pre-packaged policy. 

New Jersey has a strong record when it comes to health care. Over 300,000 New Jersey residents have signed up for unlimited access to health care coverage under the ACA, and New Jersey is one of the few states that adopted an individual insurance mandate after the federal mandate was repealed in 2019. This is great news for those seeking group plans in the great state of New Jersey.

New Jersey Large Group Health Insurance Plans

Large employers with a responsibility to provide large group health insurance (SHOP plan) to their employees have the flexibility to determine what type of coverage they offer, as long as it meets the ACA standards. Those requirements include affordability and minimum essential benefits. The company can offer one plan option or several. The cheapest insurance must be designed to pay at least sixty percent of the anticipated costs for the subscriber, and the premium charged to the worker can’t exceed 9.12 percent of their gross pay.

The employer can decide between service structures, choosing a traditional indemnity plan, an HMO, PPO, or a Point of Service option. If the employer has more than one option, it can offer the same subsidy for each, even if that means the employee would pay more for some plans. But at least one must satisfy the affordability standard.

New Jersey Small Business Health Insurance Plans

Small businesses that offer employees health insurance may be hesitant to consider self-funded programs due to the risk of high claims. Still, self-funding can provide the business with savings, flexibility, and improved cash flow, making it attractive to small companies as well as larger firms. Some employers are opting for a blended version called level funding.

Small business health combines a small portion of self-funding with a stop-loss insurance policy to reduce exposure to large claims. The approach can deliver the anticipated savings but protect small employers from potentially catastrophic losses.

New Jersey Employee Benefits Plans and Employee Benefits Packages

In New Jersey, full-time employees are entitled to up to forty hours of paid sick leave annually. Employees are also allowed up to twelve weeks of paid family leave which can be used in connection with the birth or adoption of a child or other reasons related to family illness or domestic violence. In addition, the New Jersey Family Leave Act provides for twelve unpaid weeks of leave in a 24-month period for similar reasons. New Jersey is one of seventeen states that require insurers to cover the cost of fertility treatments for covered dependents needing reproductive assistance.

New Jersey is a competitive job market, and as a result, employers understand the value of a robust benefits package. In addition to required sick leave and family leave, many companies add vacation pay to the benefits program.

In some cases, businesses are moving toward a policy that provides a bucket of paid time off that the employee can use for whatever purpose they need, whether that is vacation time, personal days, illness, or some other reason. These policies either specify the number of hours available or opt for “unlimited” time off, which is always subject to approval by the employee’s manager.

New Jersey is one of several states that have recently enacted laws requiring or encouraging employers to establish retirement savings plans for their employees. The New Jersey Secure Choice Savings Program requires participation by employers with 25 or more workers. It allows the participants to generally enroll in a state-run Individual Retirement Account, funded by payroll deduction with pre-tax credit contributions.

The following services are offered by Taylor Benefits to all clients:

As an independent health insurance provider, Taylor Benefits can provide custom plans not limited by insurance company policies or state insurance mandates. Pick and choose the healthcare services your group needs to be successful! In addition, essential health care benefits, which must be included in every plan can be viewed here, courtesy of the federal government.

New Jersey Group Health Insurance & Employee Benefit Plans

We offer free, no-obligation consultations. Learn which policies and plans work best for your group by contacting us online. New Jersey’s state motto of “Liberty and Prosperity” is aligned with our goal to offer our clients the freedom to choose their health care group plans.

Learn more about employee benefit packages in New Jersey.

Relevant Statistics

  • Approximately 85% of New Jersey employers offer group health insurance to their employees.
  • The average annual premium for a New Jersey group health insurance plan is $6,500 per employee.
  • Over 90% of New Jersey residents who are employed have access to employer-sponsored health insurance.
  • More than 75% of small businesses in New Jersey with less than 50 employees provide group health insurance coverage.
  • The New Jersey group health insurance market has grown by more than 20% in the past five years.

General Facts

  • New Jersey requires employers with 2 or more employees to offer group health insurance.
  • Group health insurance in New Jersey provides coverage for a group of individuals, such as employees of a company.
  • Employers typically share the cost of group health insurance premiums with their employees.
  • Group health insurance plans in New Jersey often offer more comprehensive coverage compared to individual plans.
  • New Jersey law prohibits discrimination based on pre-existing conditions when offering group health insurance.

New Jersey and the ACA

New Jersey residents benefit greatly from the provisions of the Affordable Care Act (ACA), which is sometimes still called Obamacare. Medicaid has been expanded since Obamacare’s inception. The state of New Jersey benefits from higher subsidies as well, which means the ACA has contributed to more widespread health coverage. Larger subsidies combined with a higher percentage of insured residents mean that the employer contribution can provide more coverage for more affordable rates.

Taylor Benefits can provide better group coverage in New Jersey than it could if your company was located in another state. This is great news for New Jersey residents.

To learn more about the health insurance offered by the State of New Jersey regarding consumer information, please see this resource from the New Jersey Department of Banking & Insurance.

Frequently Asked Questions About Health Insurance And Employee Benefit Plans in New Jersey

Here are answers to some frequently asked questions about health insurance in New Jersey:

Which Large Group Health Insurance Providers Are in New Jersey?

In addition to providing group health insurance, Taylor Benefits Insurance can connect you to some of the nation’s most reputable providers and any other information you need about benefits programs. Over the years, we have proven that we can always find you a great deal on large group coverage plans.

Below is a list of the insurance providers we work with:

  • HCSC Group
  • Blue Shield
  • eHealthInsurance
  • Coventry Corp. Group
  • HIP Insurance Group Humana Group
  • Kaiser Foundation Group
  • Unitedhealth Group
  • Carefirst Inc. Group
  • UHC
  • Blue Cross
  • State Farm
  • Metropolitan Group

How Do Small Business Group Health Insurance Plans Work in New Jersey?

Small businesses don’t have an ACA obligation to provide sponsored health insurance. If your company wants to offer insurance coverage, simply choose from these four structures, depending on which matches your needs:

Indemnity Health Insurance Plans

Members of indemnity plans are generally able to choose any direct primary care doctor or hospital (Sanitas Medical Center, Everside Health, R-Health, formerly Paladina Health) to treat them for their medical needs. Insurance companies pay a set percentage of the bill. Some employees may be required to pay for some services upfront and then apply for reimbursement from their insurance provider.

HSA-Qualified Health Insurance Plans

Health Savings Accounts (HSAs) are typically used with PPO plans. A health savings account allows its members to set aside money – before taxes – for future medical expenses. However, the plan must meet the IRS’ requirements for a high deductible in order for subscribers to qualify for the HSA.

PPO Health Insurance Plans

Many health insurance plans are structured as preferred provider organizations or PPOs. For subscribers to receive the most financial benefit, they must seek care from a provider within the network. Members can use services outside the network but will incur additional cost.

HMO Health Insurance Plans

Health Maintenance Organizations (HMOs) are health insurance plans that provide health care services through a network of providers that exclusively contract with them or accept their membership. HMO plan participants are typically required to select a primary care physician (“PCP”) to oversee most of their health care and refer them to specialists if necessary. Often an HMO subscriber isn’t covered for care obtained outside the HMO unless it’s for an emergency.

What Are the Different Types of Health Benefits Offered in New Jersey?

New Jersey companies and eligible employees can take advantage of the following benefits packages offered by Taylor Benefits Insurance Agency:

  • health coverage
  • retirement & pension
  • section 125 cafeteria
  • HSA
  • life insurance
  • long term care
  • ACA (Affordable Care Act)
  • Disability insurance, both short and long term
  • 401k
  • dental coverage
  • vision insurance

How Much Do Employers Pay for Health Insurance?

The cost of health insurance is rising in New Jersey, as it is across the country. Large employers must offer an affordable policy to their workers. The ACA definition of affordable provides that the employees’ premiums can’t be more than 9.12 percent of their gross income for a bronze-level plan.

Written by Todd Taylor

Todd Taylor

Todd Taylor oversees most of the marketing and client administration for the agency with help of an incredible team. Todd is a seasoned benefits insurance broker with over 35 years of industry experience. As the Founder and CEO of Taylor Benefits Insurance Agency, Inc., he provides strategic consultations and high-quality support to ensure his clients’ competitive position in the market.

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