New Jersey: Grant opportunity for community organizations to help NJ residents enroll in health coverage

via the NJ Dept. of Banking & Insurance:

Open Enrollment Period through Get Covered New Jersey Begins November 1, 2025

TRENTON — New Jersey Department of Banking and Insurance Commissioner Justin Zimmerman 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 2026. 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.

“The Murphy Administration continues to invest in local outreach as part of its commitment to increase residents’ access to quality, affordable health insurance that meets their needs,” said Department of Banking and Insurance Commissioner Zimmerman. “Enrollment assistance is key to helping consumers access coverage, especially for the upcoming plan year. These local organizations support New Jerseyans in their own communities, offering one-on-one assistance, and connecting residents to health coverage and financial help available through Get Covered New Jersey.”

The $5 million grant program continues to be funded by the user fees that support the Department’s operation of the State-Based Marketplace. Navigator outreach efforts include public information events and activities meant to connect and educate consumers about their health coverage options and the financial assistance available. Consumers may access Navigator assistance in person or remotely throughout the state.

The Murphy Administration has significantly increased its investment in Navigators since 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 27 Navigators—up from $400,000 for just one Navigator under the federal government in 2019. The State began operating as a State-Based Marketplace on November 1, 2020 under a law (P.L. 2019 c. 141) signed by Governor Phil Murphy and began offering state-level subsidies to further lower health plan costs.

During the most recent Open Enrollment Period, a total of 513,217 residents signed up for health insurance through Get Covered New Jersey — a record high and 108 percent increase since the Murphy Administration took over operations of the marketplace in 2020 for plan year 2021. The average amount of financial help received for 2025 coverage is $589 per person per month, or $7,068 per person per year, as a result of federal and state savings.

Most residents enrolling at Get Covered New Jersey qualify for financial help and many individuals receiving financial help have access to a health plan at a cost of $10 a month or less. 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 ($90,360 for an individual and $187,200 for a family of four).

Navigator organizations are especially important in the year ahead to assist consumers with understanding upcoming federal policy changes expected to state-based marketplaces. On June 25, the Centers for Medicare and Medicaid Services finalized a new rule that makes significant changes to eligibility and enrollment for all health insurance Marketplaces, including Get Covered New Jersey. Federal legislation was also passed by Congress and enacted on July 4 that makes changes to Healthcare.gov and State-based marketplaces.

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 the regulatory requirements outlined by the Centers for Medicare and Medicaid Services and the Department’s requirements in the Request for Applications. Current Navigators as well as organizations seeking to become Navigators will have the opportunity to apply for funding for the 2025–2026 year to support enrollment assistance.

All assisters—inclusive of Navigators, Certified Application Counselors, and Brokers—will 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.

Grantee activities will include outreach and education year-round for 2026 coverage, including in advance of and during the Open Enrollment Period that will run from November 1, 2025 until January 31, 2026. 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 for funding for the New Jersey State Navigator Program was released today. Organizations have until September 4, 2025 to apply.