NJ DEPARTMENT OF BANKING AND INSURANCE ANNOUNCES GRANT OPPORTUNITY FOR COMMUNITY ORGANIZATIONS TO HELP NEW JERSEYANS ENROLL IN HEALTH COVERAGE

The following information was released by the New Jersey Department of Banking and Insurance:

The New Jersey Department of Banking and Insurance today announced a total of $5 million in available grant funds for community organizations to apply to serve as state-certified Navigators for the Get Covered New Jersey Open Enrollment Period and throughout 2027. Navigators offer free, unbiased, community-based education and assistance to consumers seeking to enroll in health insurance through Get Covered New Jersey, the State's Official Health Insurance Marketplace.

"Enrollment assistance is key to helping consumers access health insurance. As federally mandated changes continue to make it more difficult for residents to enroll and afford coverage, support from these local organizations is vital in helping New Jerseyans understand their coverage options," said Acting Commissioner Susan Ochs. "Navigators offer free one-on-one assistance to support New Jersey consumers in their own communities, connecting them to health coverage and financial help available through Get Covered New Jersey."

Navigator outreach efforts include public information events and activities meant to educate consumers about the importance of health coverage, plan options and the financial assistance available. Consumers may access Navigator assistance in person or remotely throughout the state year round.

The Open Enrollment Period for coverage through Get Covered New Jersey will run for three months, from November 1, 2026 through January 31, 2027. The Centers for Medicare and Medicaid Services Marketplace "Patient Protection and Affordable Care Act; Marketplace Integrity and Affordability Final Rule" had mandated a nine-week Open Enrollment Period for the 2027 plan year but that has been blocked due to a legal challenge.

Federal changes significantly impacted all Affordable Care Act health insurance marketplaces around the country, including Get Covered New Jersey. Last year, Congress failed to extend federal enhanced premium tax credits for consumers purchasing coverage through health insurance marketplaces, and as a result tens of thousands of those initially enrolled in health plans through Get Covered New Jersey, dropped their coverage as of April 15, 2026. Consumers are now burdened with higher premiums and out-of-pocket costs for most health insurance plans.

Despite reduced federal help, most residents enrolling through Get Covered New Jersey qualify for financial help. State subsidies, called New Jersey Health Plan Savings, are available to eligible consumers with an annual household income of up to 600 percent of the federal poverty level ($93,900 for an individual and $192,900 for a family of four). Navigators play an important role in educating consumers about what financial help they qualify for.

All Marketplace programs are required to operate and fund a Navigator program. To be eligible for funding through the grant program, organizations must demonstrate that they comply with federal regulatory requirements and the Department's requirements in the Request for Applications. Current Navigators as well as organizations seeking to become Navigators have the opportunity to apply for funding for the 20262027 year to support enrollment assistance.

The $5 million grant program continues to be funded by the user fees that support the Department's operation of the State-Based Marketplace. The State began operating the Navigator program in 2019 and has taken numerous actions to improve access to health coverage. Last year, the Department awarded $5 million to 30 Navigatorsup from $400,000 for just one Navigator under the federal government in 2019. New Jersey began operating a State-Based Marketplace on November 1, 2020, under a state law (P.L. 2019 c. 141) and began offering state-level subsidies to further lower health plan costs.

All assistersinclusive of Navigators, Certified Application Counselors, and Brokerswill be required to complete State training and certification to assist consumers with health insurance enrollment on the State Marketplace. Among other requirements, organizations applying for funding must demonstrate established credibility and experience in the areas of health or social services, specifically in supporting consumers with income-based applications for government programs; navigating the complexities of the health care system; health insurance education and enrollment support; consumer or patient advocacy, or other activities where the entity has advocated on behalf of or directly assisted and educated consumers seeking support in getting access to coverage or health care services.

Navigators also assist consumers who are eligible to enroll in coverage outside of Open Enrollment, through Special Enrollment Periods throughout the year.

Open Enrollment is the only time of year residents can enroll in a plan through Get Covered New Jersey unless they have a major life event, such as getting married, moving, having a baby, pregnancy, losing NJ FamilyCare coverage (Medicaid/CHIP), or losing employer-sponsored coverage.

A Request for Applications (nj.gov/dobi/financial/) for funding for the New Jersey State Navigator Program was released today. Organizations have until July 31, 2026, to apply.

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ABOUT GET COVERED NEW JERSEY

Get Covered New Jersey is the state's Official Health Insurance Marketplace, operated by the New Jersey Department of Banking and Insurance, where New Jerseyans can find quality insurance from private health insurance companies. Get Covered New Jersey is the only place where individuals who qualify can get financial help to reduce premium costs. Consumers can then compare health insurance plans and choose the plan that best fits their health needs and budget. Depending on their income, some consumers may qualify for low-cost or free coverage from NJ FamilyCare. Get Covered New Jersey was established by state law and created by New Jersey, for New Jersey. For more information, visit GetCovered.NJ.gov.

Open Enrollment begins November 1, 2026. However, residents may still enroll in health insurance coverage or change plans outside of the annual open enrollment period if they qualify for a Special Enrollment Period, including if they are no longer eligible for NJ FamilyCare or indicated on their tax returns that they are interested in the New Jersey Easy Enrollment Health Insurance Program.