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NJ SEH Adopts New Proposal

10/19/2016


On Wednesday, October 12, 2016, the NJ DOBI adopted the proposed changes to the Small Employer Health Benefits Program. Attached is the 25 page bulletin for your review, but here are just some of the key points you should be aware of:

  • These changes will become effective January 1, 2017 and renewal dates after that
  • Owners CANNOT be covered if they are the ONLY people covered in the group. (Page 19)
  • Eligibility of at least 25 hours per week remains. This is for enrollment purposes only.

An individual and a spouse, if at least one of them owns the business CANNOT be considered an employee. Carriers will have to be more transparent as to how they arrived at “allowed amounts” for out of network charges. Carriers have the option to use Fair Health or another method to determine out of network allowances

If you have any question regarding these changes, please contact Dave Mordo at Dave_Mordo@ajg.com.

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