Nongroup Enrollment / Change Request - New Jersey

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Nongroup Enrollment / Change Request - New Jersey

Nongroup Enrollment/Change Request is a legal document that was released by the New Jersey Department of Banking and Insurance - a government authority operating within New Jersey.

FAQ

Q: What is a Nongroup Enrollment/Change Request?
A: A Nongroup Enrollment/Change Request is a form used in New Jersey to enroll or make changes to an insurance plan outside of the group coverage offered by an employer.

Q: Who can use a Nongroup Enrollment/Change Request form?
A: Any individual in New Jersey who is not eligible for group coverage through an employer can use a Nongroup Enrollment/Change Request form.

Q: What changes can be made using a Nongroup Enrollment/Change Request form?
A: Using this form, individuals can enroll in a new insurance plan, make changes to their existing plan, or terminate their coverage.

Q: Is there a deadline for submitting a Nongroup Enrollment/Change Request form?
A: Yes, there are specific open enrollment periods during which you can submit a Nongroup Enrollment/Change Request form. Outside of those periods, you may be eligible for a special enrollment period if you experience a qualifying life event.

Q: What are examples of qualifying life events for a special enrollment period?
A: Examples of qualifying life events include getting married, having a baby, losing other health coverage, or permanently moving to a new area.

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Form Details:

  • Released on November 1, 2017;
  • The latest edition currently provided by the New Jersey Department of Banking and Insurance;
  • Ready to use and print;
  • Easy to customize;
  • Compatible with most PDF-viewing applications;
  • Fill out the form in our online filing application.

Download a printable version of the form by clicking the link below or browse more documents and templates provided by the New Jersey Department of Banking and Insurance.

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