NJ health insurance enrollment for 2022: Costs are up, so is aid

TRENTON — Open enrollment for health insurance has begun under the state’s Get Covered New Jersey marketplace, after reaching record levels earlier this year with more than 283,000 participating residents.

The state-level marketplace — which rolled out in 2020 — is offering more plan choices and record levels of financial help available for 2022, with four insurance carriers offering plans.

Ambetter from WellCare of New Jersey is joining AmeriHealth, Horizon Blue Cross Blue Shield of New Jersey and Oscar as available carriers.

Healthcare premium rates will increase on average by 7.9% over 2021 in the individual market, according to state officials in late October.

However, about 90% of state residents enrolling will qualify for financial assistance. Most will continue to have access to a plan at a cost of $10 a month, or less.

Rates in the Small Employer Health Benefits Program will increase on average by 10.4% over last year.

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Why are monthly premiums up?

Individual premiums statewide rose an average of 3.3% for 2021, after increasing by about 8.7% in 2020 under the federal Affordable Care Act.

The 2022 rate increases are chalked up largely to an increase in health care costs, according to information submitted by the carriers.

Amid the COVID-19 pandemic, insurers in 2020 saw a decrease in medical claim costs due to reduced utilization of services, such as postponement of elective surgeries and other medical services.

Many of those procedures have been pushed into this year and next.

What is the average 2022 monthly premium?

Those earning an annual salary of up to 600% of the federal poverty level ($76,560 for an individual and $157,200 for a family of four) are eligible to receive state assistance.

No one will pay more than 8.5% of their income for health insurance (based on a benchmark plan), under the American Rescue Plan signed in March by President Joe Biden.

Average lowest monthly premiums in-state for 2022 have been estimated as $349 per person at the Bronze level, $400 per person at the Silver level and $600 per person at the Gold level, according to analysis by the Kaiser Family Foundation.

The average benchmark premium was $424 per person for the upcoming year, in the same analysis.

Who qualifies for financial help?

Those earning an annual salary of up to 600% of the federal poverty level ($76,560 for an individual and $157,200 for a family of four) are eligible to receive state assistance.

No one will pay more than 8.5% of their income for health insurance (based on a benchmark plan), under the American Rescue Plan signed in March by President Joe Biden.

For dependent children under age 20, the monthly premium is capped at the sum of the premiums for three children, according to the state.

When do I need to enroll?

Those needing to purchase health coverage through the state marketplace can compare available 2022 health and dental plans, then choose a plan by Dec. 31 for coverage beginning Jan. 1, 2022.

Otherwise, consumers can enroll by Jan. 31, 2022 for coverage beginning Feb. 1, 2022.

The COVID-related enrollment period has overlapped with the start of open enrollment for 2022 coverage.

A total of 53,554 people had already signed up for coverage seven months into the Special Enrollment Period between February to Aug. 1, opened by the state due to COVID-19.