State RegulationsNJ specificDifficulty 3/5
Two New Jersey applicants seek health coverage: one is a freelance illustrator buying a policy for herself, and the other is a small manufacturing firm buying coverage for its employees. How do the state's health reform programs apply to these two purchasers?
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Answer & full 3-part explanation (select an option above, or peek)
Why B is correct
New Jersey's reform chapter organizes the two markets separately. The Individual Health Coverage Program, beginning at N.J.S.A. 17B:27A-1, governs carriers writing individual health coverage — the freelance illustrator buying for herself. The Small Employer Health Benefits Program, beginning at N.J.S.A. 17B:27A-17, governs the small-employer market — the manufacturing firm buying for its employees. The New Jersey Department of Banking and Insurance administers both programs, each matched to its own market.
Why the other options are wrong
- A) The firm is a group purchaser buying for employees, so it falls in the small-employer program, not the individual program.
- C) The individual purchaser is squarely within the Individual Health Coverage Program, and no purchaser is covered by both programs at once.
- D) The chapter keeps the individual and small-employer markets in separate program frameworks; they are not merged.
Memory hook
Solo buyer = IHC; firm buyer = SEH. Match the purchaser to the program.