The state is authorized as state-based exchange on the federal platform

The New Jersey Department of Banking and Insurance announced on Thursday the state will dedicate up to $2 million in grant funding for state navigators and other organizations to provide enrollment assistance to New Jersey residents shopping for health coverage during this year’s open enrollment period, as part of the state’s move to a State-Based Exchange on the Federal Platform.

The increased investment, beyond what the federal government would have provided in outreach funding, is part of the state’s ongoing work to improve access to quality affordable coverage for New Jersey residents. The Affordable Care Act open enrollment period for plan year 2020 runs from Nov. 1, 2019 to Dec. 15, 2019.

In June, Gov. Phil Murphy signed legislation to establish a State-Based Health Exchange in New Jersey. As part of the transition, the state will operate a State-Based Exchange on the Federal Platform (SBE-FP) for plan year 2020 and a State-Based Exchange (SBE) for plan year 2021.

The department was notified by the U.S. Centers for Medicare and Medicaid Services on Sept. 24 of authorization to serve as a State-Based Exchange on the Federal Platform.

While an SBE-FP is responsible for activities such as certifying qualified health plans (QHPs), managing assister programs, and providing stakeholder outreach and education, the SBE-FP still relies on the Federally-facilitated Exchange’s (FFE) information technology systems, FFE consumer call center, and FFE eligibility and enrollment services through HealthCare.gov.

Eligible organizations for grant funding include organizations that previously served as Navigators in the state and organizations serving as Certified Application Counselor Designated Organizations (CDOs), which oversee Certified Application Counselors.

Navigators help consumers enroll and re-enroll in a health insurance plan through the SBE-FP and will also provide outreach and education services. Funding to CDOs will allow them to conduct outreach projects to connect New Jersey residents to affordable coverage. Eligible CDOs must have served in the state since 2019 and must be designated by the state to serve as a CDO in 2020. Former federal Navigators in New Jersey that choose not to apply for Navigator funding are also eligible to apply for CDO Outreach Project Grant funds.

All applicants for CDO outreach project funding must apply for and receive designation by the state to serve as a CDO.

CMS awarded a total of $10 million in navigator grant funding nationally to federally-facilitated Exchange states. New Jersey was set to receive $300,000 in federal funding for 2020, reduced from $400,000 in funding made available to the state last year.

As part of the $2 million grant funding, the department is awarding $300,000 to the Center For Family Services (CFS) to continue serving as a Navigator for 2020.

CFS served as the state’s only federal Navigator in New Jersey in 2019 and was the sole New Jersey applicant for federal Navigator funding prior to the program transfer. As part of the transition, the Department accepted Center for Family Services’ federal application for state funding and will permit the organization to apply for additional funds through the Request for Applications.

The $2 million grant program will be funded by the assessment authorized by Public Law 2019 c. 141.

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