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Call: 2-1-1 for general information (24/7) or 1-800-962-1253 for medical information (24/7)
Text: NJCOVID to 898-211
Visit covid19.nj.gov or nj.gov/health for additional information

NJ Shared Responsibility Requirement

Updated Guidance for Health Coverage Filings (March 19, 2020)

Starting with Tax Year 2019, the New Jersey Health Insurance Market Preservation Act (Market Preservation Act) requires third-party reporting to verify health coverage information supplied by individual payers of New Jersey’s Income Tax.

Coverage providers, please note that you must:

  • By May 15, 2020, provide the New Jersey Division of Taxation with a 1095 health coverage form for each primary enrollee who was a New Jersey resident and to whom the filer provided minimum essential coverage in 2019. This applies to both part-year and full-year New Jersey residents. For 1095 filing purposes, a part-year resident is a primary enrollee who lived in New Jersey for at least 15 days in any month.
  • Ensure that New Jersey receives the appropriate 1095-B or 1095-C form. Use the 1095 forms that the IRS has posted for the 2019 Tax Year. (See 1095-B or 1095-C.)  Instructions on which form to use are below.
  • Ensure that each primary enrollee who was a New Jersey resident or part-year New Jersey resident in 2019 receives at least one 1095 form that includes health coverage information. Sending a single 1095 to each primary enrollee is sufficient for both State and federal purposes. You do not have to send separate 1095 forms to spouses, dependents, or adult children of primary enrollees.
  • Meet the March 2, 2020, deadline for sending 1095s to primary enrollees. No deadline extension is expected.

PLEASE NOTE: New Jersey is not following IRS practices on 1095-B forms for the 2019 tax year. The IRS is allowing some filers to notify primary enrollees that a 1095-B form is available if they request it. New Jersey requires that a 1095-B be sent to each primary enrollee.

Out-of-State Employers Who Employ New Jersey Residents Have the Same Filing Requirements as in-State Businesses.

These requirements are not limited to businesses that withhold New Jersey payroll taxes. If you are an out-of-State employer who provides health coverage, you must ensure that we receive any required 1095 document for each New Jersey resident you employ. Insurers, government agencies, exchanges, multiemployer plans, and all others responsible for reporting Minimum Essential Coverage on behalf of New Jersey residents also must file the required information with the State.

Guidance on What Forms Are Required From Whom

New Jersey will not require 1094 forms for 2019, though we will accept them if a coverage provider sends them. 

The State expects to receive filings of Form 1095-CEmployer-Provided Health Insurance Offer and Coverage. Filers of Form 1095-B, Health Coverage, should use that form for New Jersey filings.

If the federal government discontinues, substantially alters, or makes unavailable Forms 1095-B or 1095-C, New Jersey will deploy similar forms and require they be sent to the State and to New Jersey taxpayers.

Forms for Coverage Obtained on Healthcare.gov or State exchanges

Insurers who provide coverage through policies sold on the federal Healthcare.gov exchange or any other exchange must provide a 1095-B to the New Jersey Division of Taxation for any primary enrollee who purchases coverage. A 1095-A or 1095-B form also must be sent to the primary enrollee.

Guidance on Forms Sent to New Jersey:

Coverage providers can send 1095 files containing data pertaining only to part-year and full-year residents of New Jersey, or, for ease of filing, New Jersey will accept the exact same 1095 data files sent to the federal Internal Revenue Service, even if the files include data about individuals who are not residents of New Jersey. Filers who provide information on non-residents of New Jersey should consult privacy and other laws pertaining to residents of other States before sending any sensitive or personal data to New Jersey.

Requirements for filings vary depending on whether an employer is fully insured, self-insured, or a participant in a multiemployer plan. The size of a company also affects reporting requirements, as detailed below:

Fully Insured:

  • Single-Company, Applicable Large Employers (ALEs). ALEs generally are companies that employed an average of at least 50 full-time-equivalent employees on business days during the preceding calendar year. Health coverage provider (the insurer) files 1095-B for each covered member of the plan.
  • Single-Company, Not an Applicable Large Employer (Non-ALE). Non-ALEs generally are companies that employed an average of fewer than 50 full-time equivalent employees on business days during the preceding calendar year. In this case, the health coverage provider (the insurer) files 1095-B for each covered member of the plan.
  • Fully Insured Employer Participating in a Multiemployer Plan. A plan sponsor (generally a board of trustees) files 1095-Bs for enrolled individuals.

Fully insured employers should:

  • Contact their insurer or multi-employer plan to discuss New Jersey’s 1095 filing requirements in advance of filing deadlines.
  • Confirm that their insurer or multi-employer plan will file the required forms and meet the applicable deadlines.
  • Understand that an employer may share liability if its insurer or multi-employer plan does not file the required 1095 forms on time.

Self-Insured:

  • Single-Company, Applicable Large Employers (ALEs).  ALEs generally are companies that employed an average of at least 50 or more full-time equivalent employees on business days during the preceding calendar year: Employer files 1095-C or 1095-B for each person who was a full-time employee for at least one month of the calendar year and for any employee who was enrolled in the self-insured plan. New Jersey requires only Parts I and III of Form 1095-C be completed, but will accept fully completed forms as well. ALE members that offer employer-sponsored, self-insured health coverage to non-employees may use Form 1095-B for these non-employees, or ALEs may file a 1095-C using Code 1G in Part II, to report for non-employees. For this purpose, a non-employee includes a non-employee director, an individual who was a retired employee during the entire year, or a non-employee COBRA beneficiary. This also applies to a former employee who terminated employment during a previous year.
  • Single Company, Not an Applicable Large Employer (Non-ALE). Non-ALEs generally are companies that employed an average of fewer than 50 full-time equivalent employees on business days during the preceding calendar year. Employer files a 1095-B for each covered employee.
  • Self-Insured Employer Participating in a Multiemployer Plan. A plan sponsor (generally a board of trustees) files a 1095-B for each covered employee.

Self-insured employers participating in multiemployer plans should:

  • Contact their multi-employer plan to discuss New Jersey’s 1095 filing requirements in advance of filing deadlines.
  • Confirm that the multi-employer plan will file the required forms and meet the applicable deadlines.
  • Understand that an employer may share liability if its multi-employer plan does not file the required 1095 forms on time.

 

Transmitting 1095 Returns

Under New Jersey’s Health Insurance Market Preservation Act, insurers, employers, government agencies, multiemployer plans, and other entities that provide health insurance must submit required information returns to New Jersey reporting on individuals’ health insurance coverage.

There is no paper filing option available.

Insurers or Employers are able to provide confidential or sensitive data to the State of New Jersey using the Division of Revenue and Enterprise Services' (DORES) MFT SecureTransport service.

Insurers or Employers can file 1095 forms in two ways.

  • Registered filers can use the Division of Revenue and Enterprise Services' (DORES) MFT SecureTransport service. MFT is the required system for filers of 100 or more forms. Taxpayers who have MFT SecureTransport service user credentials use them to submit the required health insurance coverage returns. If you do not have a MFT SecureTransport service account, or need technical specifications and guidance, contact DORES. Once DORES receives your request and authorizes your account, you can expect to receive instructions on how to submit your health insurance coverage returns. If you already have a MFT SecureTransport service account, you can use the same account to transmit the 1095 files provided the filename starts with NJHIM. New Jersey will accept returns submitted in bulk filing by users of MFT SecureTransport. A company responsible for submitting files for multiple companies can establish a single MFT SecureTransport Account and submit a single file containing the information for the various companies. Files must be under 12 MB (12,000KB) in size and may be split into multiple files. We will not accept files in a zipped file format. You will receive a submission receipt upon successful transmission which will serve as the acknowledgement. This receipt will be sent to the email associated with the MFT SecureTransport Account.
  • As an alternative to MFT SecureTransport, coverage providers with under 100 forms can use the Fillable Form NJ-1095 to file one form at a time. The NJ-1095 form is valid for federal filers of either 1095-B or 1095-C forms.

If you are required to submit a correction file to the IRS, New Jersey will also require you to submit the correction file.

XML Schemas and other information for transmitters are provided by tax year:

2019 Tax Year will accept NJ-1095, 1095A, 1095-B, or 1095-C.

Information About Adult Children Under Age 26
Under the federal Affordable Care Act, adult children up to age 26 may be covered by their parents’ health plan.

NJHIMPA does not require Forms 1095-B or 1095-C be provided separately to children covered by their parents’ health plans. This applies regardless of their residency, beyond the requirement under 26 U.S.C. s.6055, as that section was in effect and interpreted on December 15, 2017.

It is recommended that employers advise employees to provide a copy of any Form 1095-B or 1095-C containing coverage information to their children residing in New Jersey


Last Updated: Thursday, 06/11/20