NJ Shared Responsibility Requirement

Guidance for Health Coverage Providers Under the Health Insurance Market Preservation Act

he 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.

Employers, insurers and other coverage providers must:

New Jersey’s 1095-C Requirements Differ From Federal Requirements

1095-C forms with only Parts I and II completed will not meet any New Jersey filing requirements. You should transmit these forms only if you cannot separate them from a file that includes other required forms that do meet filing requirements.

If you have any questions, the state has provided a contact page on it’s web site to submit questions.

New Jersey 1095-B Requirements Differ From Federal Requirements:

New Jersey does not follow all IRS practices on 1095-B distribution. The IRS allows some coverage providers to notify primary enrollees that a 1095-B form is available if they request it. In contrast, New Jersey requires that a 1095 form be sent to each primary enrollee.

The requirement to file is not limited to businesses that withhold New Jersey payroll taxes. If you are an out-of-State employer who provides health coverage, transmit to us 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.

Out-of-State Employers:

Out-of-state employers and other coverage providers have the same filing requirements as in-state businesses and insurance companies.

Guidance on What Forms Are Required From Whom

New Jersey does not require coverage providers to transmit 1094 forms, though we will accept them if a coverage provider sends them as part of a larger file that includes 1095 forms.

New Jersey will accept the NJ-1095 form from any filer. The State also will accept filings of federal 1095-C forms, Employer-Provided Health Insurance Offer and Coverage, if Parts I and III are completed or the form is fully completed. Filers of fully completed Form 1095-B. Health Coverage, also can use that form for New Jersey filings.

Insurers Must File for Coverage Obtained on New Jersey’s State Health Insurance Exchange

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

Guidance on Forms Sent to New Jersey

Coverage providers and employers who file more than 100 1095 forms can send files containing data pertaining only to part-year and full-year residents of New Jersey. However, the Division of Taxation also will accept files that 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 about non-residents to New Jersey.

Larger files can send these forms in the XML format sent to the IRS, as long as the files are fully completed 1095-B or 1095-C forms. They can also be sent using the pipe delimited flat text format. State of New Jersey requirements are not met by 1095-C forms with only Parts I and II completed. Do not send 1095-C forms with only Parts I and II completed unless they are part of a larger file that includes files that do meet New Jersey requirements.

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:

Fully insured employers should:


Self-Insured Employers Participating in Multi-Employer Plans Should:

Transmitting 1095 Returns

Paper Filing?

There is no paper filing option available.

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.

Insurers or Employers can file 1095 forms in two ways:

If you are required to submit a correction file to the IRS, New Jersey will also require you to submit the correction file. Size limits for MFT (Axway) filings are at 12 MB for both initial filings and corrections.

XML Schemas and other information for transmitters are provided by tax year. Please see the Generic XML Templates: Form 1095B and Form 1095C to view samples of the minimum information that New Jersey needs to successfully process a 1094B/1095B or 1094C/1095C file submission, with our required XML formatting. In particular, the XML opening tags and closing tags must be formatted precisely as in our samples. Your file may include additional fields, as long as our required fields are included with the required formatting. The sample has several scenarios, including annual and monthly coverage, employees/responsible individuals with and without dependents, and a dependent without a Social Security Number. Note that New Jersey is seeking a record of all Covered Individuals; if you have no Covered Individuals to report, you do not need to submit a 1094/1095.

New Jersey is also developing a pipe delimited flat text format. Details on the pipe delimited format will be released when the schema are available.

2020 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 in 2020. NJHIMPA does not require 1095-B forms 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 containing coverage information to their children residing in New Jersey.