BSC Insurance - Group Health insurance, business insurance, nj insurance company, affordable life insurance, IRA, insurance health care

N.J. Continuation

Frequently Asked Questions: N.J. Continuation

What is N.J. continuation?
Which employers must offer continuation?
Are there notification requirements?
What is the election period?
For what length of time may an employee or dependent continue?
Who pays the premium and how much is it?
What coverage must be continued?
Are church groups eligible for continuation?
What are the Qualifying Events?
Are Domestic Partners eligible for N.J. continuation?
Which employees are eligible for continuation?
Can employees or dependents add and/or delete dependents?
What changes were made effective 3/7/05?

1. What is N.J. continuation?
It is a N.J. State Law by which employees who have terminated or whose hours have fallen to below 25 hours per week and lose medical coverage can continue on the plan at their expense.

2. Which employers must offer continuation?
N.J. continuation applies to any size insured group in the 2-50 eligible employee market to whom Federal COBRA does not apply.

3. Are there notification requirements?
The employer must notify an employee within 14 days of the Qualifying Event. There is no obligation to notify dependents.

4. What is the election period?
Election happens 30 days from the Qualifying Event or when the notice is mailed.

5. For what length of time may an employee or dependent continue?
Qualifying employees can elect for continuation up to 18 months. Employee death or divorce allows dependents to continue for 36 months. Dependent children who "age out" or who are no longer full-time students may continue for 36 months. Adult Children covered under Chapter 375 do not have continuation rights unless the parent or employee has a Qualifying Event and elects continuation. Members who qualify for Medicare disability may extend continuation from 18 to 29 months.

6. Who pays the premium and how much is it?
Continuees pay 100% of the premium. The employer may charge an additional 2% surcharge. For those who extend coverage due to Medicare disability, 150% of the total premium rate may be assessed.

7. What coverage must be continued?
When a Qualifying Event occurs, any medical coverage must be allowed to be continued. The continuee may not change plans unless they move out of the plan service area and another plan is offered by the employer. Certain carriers permit dental continuation, but this is not required.

8. Are church groups eligible for continuation?
Yes.

9. What are the Qualifying Events?
Termination of employment for other than gross misconduct and reduction of hours to below 25 are Qualifying Events. Dependents can continue with the employee or have their own right(s) if the employee dies or divorces the spouse, or when they no longer qualify due to age, marriage or loss of full-time student status.

10. Are Domestic Partners eligible for N.J. continuation?
N.J. Small Group contracts define Domestic Partners as spouses. They are therefore eligible.

11. Which employees are eligible for continuation?
Any employee or dependent covered by a N.J. fully insured contract qualifies for continuation. If a member moves out of the service area, the employer is not obligated to create another plan.

12. Can employees or dependents add and/or delete dependents?
If the employer’s written plan includes an employee and dependent contract, newly acquired dependents of the former employee can be added.

13. What changes were made effective 3/7/05?
Qualifying Events allow employees to continue 18 months and dependent events allow continuation for 36 months. (This does not apply to ineligible Adult Children.) If Medicare disability is retroactively applied to a date within the first 60 days of COBRA coverage, an extension to 29 months is allowed.