New Jersey ACA Filing Requirement

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New Jersey ACA Filing Requirement

October 22, 2019

The State of New Jersey requires employers, insurers and other providers of health coverage to send health care coverage information to the State starting with Tax Year 2019. The health care coverage returns will be used by the State to verify that each New Jersey resident has health insurance, has a valid exemption from having health insurance or pays a penalty. The New Jersey requirement, set forth in the New Jersey Health Insurance Market Preservation Act (HIMPA), is a continuation of the federal Affordable Care Act (ACA).

New Jersey requires Form furnishing and transmissions under HIMPA, just like the IRS requires Form furnishing and transmissions under ACA. 

Who Must Comply? 

HIMPA applies to both New Jersey Employers and to Out-of-State Employers who employ New Jersey residents. 

Questions and Answers about HIMPA

Q – What is the New Jersey Market Preservation Act? 
A – The New Jersey Health Insurance Market Preservation Act is a continuation of the federal Affordable Care Act. It requires every New Jersey resident to obtain health insurance that offers minimum essential coverage, have a valid exemption, or make a Shared Responsibility Payment. 

Q – How does a New Jersey resident tell the State of New Jersey if he or she has minimum essential health coverage? 
A – New Jersey residents must indicate coverage on their New Jersey Income Tax returns. 

Q – How does the State of New Jersey confirm that a resident has minimum essential health coverage?
A – Starting with Tax Year 2019, New Jersey requires third-party reporting to verify health coverage information supplied by individual income taxpayers. Employers and all other providers of Minimum Essential Coverage to New Jersey residents must send health-care coverage returns to the State for the 2019 Tax Year. Filers will transmit coverage returns through New Jersey’s system for processing W-2 forms. 

Q – What information will the coverage returns contain?
A – Coverage returns will contain the information specified by federal Internal Revenue Service (IRS) rules and regulations for 1094 and 1095 filings.  

Q – Do employers send all 1094/1095 information or just information for New Jersey residents? 
A – New Jersey encourages companies to send data pertaining only to New Jersey full-year and part-year residents, only. However, for ease of filing, New Jersey will accept the same 1094/1095 data files sent to the IRS, even if they include data about individuals who are not residents of New Jersey.  

Q – When does the first New Jersey HIMPA filing have to be made? 
A – Filers must provide 2019 coverage information electronically by March 31, 2020. 

Q – Do we have to comply if our company is not based in New Jersey? 
A – Out-of-State employers who employ New Jersey residents have the same filing requirements as in-State businesses. These requirements are not limited to businesses that withhold New Jersey payroll taxes. If you are an out-of-State employer, you must ensure that the State of New Jersey receives any required 1095 document for each New Jersey resident you employ.  

Q – Who exactly will be sending forms to New Jersey? 
A – Requirements for the filings vary depending on whether an employer is fully insured, self-insured, or a participant in a multi-employer plan. The size of a company also affects reporting requirements. The filing requirements mirror federal ACA filing requirements. 

Q – What happens with dependents who reside in New Jersey if the employee does not reside in New Jersey? 
A – New Jersey HIMPA does not require Forms to be provided separately to children covered by their parents’ health plans. This applies regardless of their residency. 


If you have additional questions, please reach out to your Lyons Companies Employee Benefits Service team or email us.