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Is There a Penalty for Not Having Health Insurance in New Jersey in 2026? How Much It Is and Who Is Exempt
Written and reviewed by Dick Tracy, licensed health insurance broker (NPN 20414610) · Published October 2, 2026
Quick answer Yes. New Jersey still charges a tax penalty for going without health insurance, even though the federal penalty has been $0 since 2019. The state calls it the Shared Responsibility Payment, and it lands on your New Jersey income tax return. The most recent amounts the Treasury has published, for tax year 2025, run from $695 to $4,908 for a single person and up to $24,540 for a family of five, depending on income. It is charged month by month, a gap of less than three months is exempt, and anyone who is not required to file a New Jersey return owes nothing. The Treasury has not printed a 2026 range yet, only an estimator, and I will not guess at one. I educate, you decide.
I'm Dick Tracy, a health insurance broker. I'm licensed in New Jersey (NPN 20414610), one of 25 states I hold a license in, and I work with 80+ carriers. My office is in Buffalo, New York, and I work with New Jerseyans on the phone or on Zoom with the documents on the screen. I came from the healthcare side of this business, so there is no gag clause on me. You get the tips, the tricks, and the traps, including one on this page: the state's own pages do not agree on the numbers.
tax year 2025, at least
tax year 2025
threshold, if that is higher
Source: New Jersey Department of the Treasury, Shared Responsibility Payment and the Division of Taxation's SRP calculators.
How much is the New Jersey health insurance penalty?
The New Jersey Treasury says the payment is generally based on your income and family size and is capped at the statewide average annual premium for bronze health plans. It prints a range, not one flat number. Here are its figures for tax year 2025, the return filed in 2026, the most recent it has published.
| Uninsured all year | Household income | Minimum | Maximum |
|---|---|---|---|
| One individual | Any | $695 | $4,908 |
| Family of five (two adults, three dependents) | $200,000 or less | $2,443 (see the note below) | $4,500 |
| Family of five | $200,001 to $400,000 | $2,433 | $9,500 |
| Family of five | $400,001 and up | $2,433 | $24,540 |
Source: NJ Treasury, Shared Responsibility Payment, 2025 tax year figures (page last updated October 30, 2025). Household income counts everyone in the household, dependents included.
The state's calculator shows where those numbers come from. It figures the payment two ways and charges the higher one: a flat $695 for each adult and $347.50 for each child under 18 (the 2025 form caps that flat amount at $2,085 per household), or 2.5% of household income above the New Jersey filing threshold ($10,000 for a single filer, $20,000 for a joint return). Check it against the Treasury's table: $200,000 minus $20,000, times 2.5%, is the $4,500 it prints for that family. For a single self-employed New Jerseyan with $80,000 of household income, the same math gives about $1,750. That is my arithmetic with the state's inputs, not a state figure, so run your own number through the 2026 estimator.
Is the penalty charged per month? And is there a cap?
Yes to both. The payment is owed only for the months you or a family member had neither coverage nor an exemption, and the state's calculator charges one-twelfth of the annual amount for each one. Coverage for even one day in a month counts for that whole month.
The ceiling is the statewide average premium for a bronze plan. Worksheet L in the 2025 NJ-1040 instructions sets it at $4,908 a year for one person, which is $409 a month, and counts no more than five people, which is where the $24,540 family maximum comes from. The cap only matters at high incomes.
The income lines: below these, you owe nothing
Two lines matter. First, the filing threshold. The Treasury says anyone not required to file a New Jersey income tax return is automatically exempt and does not have to file just to claim it. Per the Division of Taxation, you must file if your gross income for the year was more than $10,000 (single, or married filing separately) or more than $20,000 (joint return, head of household, or qualifying widow or widower).
Second, the poverty line exemption, code A-3: household income at or below 138% of the federal poverty level, as the Treasury lists it.
| Family size | Household income at or below | Family size | Household income at or below |
|---|---|---|---|
| 1 | $21,598 | 5 | $51,957 |
| 2 | $29,187 | 6 | $59,548 |
| 3 | $36,778 | 7 | $67,137 |
| 4 | $44,367 | 8 | $74,728 |
Source: NJ Treasury, Claim Exemptions, poverty line exemption A-3, as posted on October 2, 2026. The Treasury does not label the year; the figures line up with the 2025 federal poverty guidelines. Add $7,590 for each additional person.
One honest note. If your income is anywhere near these lines, you are very likely eligible for NJ FamilyCare or for a marketplace plan with a large subsidy. The lines by family size are on my GetCoveredNJ income limits 2026 page.
Who is exempt from the New Jersey penalty?
You claim an exemption through the Division of Taxation's NJ Insurance Mandate Coverage Exemption Application, then report it on Schedule NJ-HCC when you file Form NJ-1040. Each exemption has a code.
| Exemption | Code on Schedule NJ-HCC |
|---|---|
| Not required to file a New Jersey return | Automatic. No return needed just for this. |
| Marketplace coverage unaffordable: lowest-cost bronze plan, after any tax credit, over 8.05% of household income | A-1 |
| Job-based coverage unaffordable: lowest-cost plan over 8.05% of household income | A-2 |
| Household income at or below 138% of the poverty level | A-3 |
| Short gap in coverage: less than three months | B-1 |
| Qualifying religious sect | C-1 |
| Health care sharing ministry, sharing since December 31, 1999 | C-2 |
| Federally recognized tribe, or eligible for Indian Health Services | C-3, C-4 |
| Incarcerated | D-1 |
| U.S. citizen living abroad, and certain non-citizens | E-1 |
| Hardships: homelessness, eviction or foreclosure, utility shut-off, domestic violence, death of a close family member, disaster, bankruptcy, unpaid medical bills | F-1 through F-12 |
Source: NJ Treasury, Claim Exemptions.
The short gap rule is tighter than most people think: less than three months. Go two months in a row with nothing, and you need coverage by the last day of the third month. At three months or longer there is no exemption for any month. Only the first gap in a year qualifies.
On the sharing ministry line: the exemption is real, but a sharing ministry is not insurance and no claim is guaranteed. I do not write them.
What coverage counts, and what does not
The law calls it minimum essential coverage. The Treasury's list includes: group coverage offered in the small or large group market, a self-insured health plan for employees, COBRA and retiree coverage, individual plans bought through the marketplace or directly from an insurance company, catastrophic plans, student health plans, Medicare Part A and Medicare Advantage, most Medicaid and NJ FamilyCare, CHIP, most TRICARE, and comprehensive VA health programs. Medicare Part B by itself does not count.
What does not count: coverage made up only of "excepted benefits." The Treasury names stand-alone vision and dental, workers' compensation, coverage for only a specific disease or condition, and plans that offer only discounts on medical services. Accident plans and fixed indemnity plans are not on the Treasury's list of qualifying coverage either. That matches how I use them: as a second layer on top of a real plan, never as the only coverage. And short-term plans are not an option at all. They are not sold in New Jersey.
The practical test I use with clients
Before you enroll in anything, get it in writing that the plan is minimum essential coverage and that you will receive a Form 1095 for your tax file. A real group plan or a real individual major medical plan can answer that in one sentence. If the answer is a paragraph, keep your wallet in your pocket.
How to stop paying the penalty without overpaying for coverage
Paying the penalty buys you nothing. A single adult hands over $695 or more and still has no coverage on the day something happens. So the real question is which coverage fits, and in New Jersey that depends on your income and your health.
Healthy, self-employed or a small business owner, income too high for a subsidy
Look at a pre-established ERISA group plan first. ERISA is the 1974 federal law that governs employer benefit plans. Group plans already exist under it, and a solo owner can be merged into one: group rates, a true PPO network (MagnaCare in New Jersey), and a policy you own. No employees required, and one simple compliance step I walk you through. The Treasury's list of qualifying coverage includes group health coverage, and before you sign anything I show you in writing how the plan is treated for the New Jersey mandate. Here are all three New Jersey doors.
Income under the subsidy lines
A subsidized plan or NJ FamilyCare may be your best deal, and I will tell you so. The trade-offs are real: narrower networks, an income estimate you have to get right, and paying credits back at tax time if you guess low. Run the 2026 subsidy calculator, preset for New Jersey, then bring me the number. The dates are on my GetCoveredNJ open enrollment 2027 page.
Between jobs or between clients
Watch the calendar. Only a gap of less than three months is exempt. Hit month three and the payment reaches back to cover the whole gap. COBRA counts as coverage, so see what COBRA costs in New Jersey before you sign up for it.
A serious diagnosis in the last five years
Guaranteed-issue coverage, for now. New Jersey individual plans cannot ask health questions, on or off the exchange. Take that protection, get well, and we revisit the other doors later.
The forms, and how the state knows
- Covered all year: you complete Part I of Schedule NJ-HCC, fill in the oval at line 53c of Form NJ-1040, and enclose the schedule with your return (2025 NJ-1040 instructions). No payment.
- Any uncovered month: claim an exemption with its code on Schedule NJ-HCC, or the payment is calculated and entered on your NJ-1040.
- How the state checks: employers, insurers, and other coverage providers must send 1095 forms to the Division of Taxation. For tax year 2025 that deadline was March 31, 2026, and your own copy was due to you by March 2, 2026.
- If you do not pay: the Treasury says it will send a bill, and the payment carries the same penalties and interest as New Jersey income tax.
- Want a number now? Use the state's free 2026 estimator for a ballpark. For your own return, ask your tax professional.
Common questions about the New Jersey health insurance penalty
Is there a penalty for not having health insurance in New Jersey in 2026?
Yes. The federal penalty has been $0 since 2019, but New Jersey has its own individual mandate under the New Jersey Health Insurance Market Preservation Act, and it is still in force. If you go without minimum essential coverage and have no exemption, the state adds a Shared Responsibility Payment to your New Jersey income tax return. The most recent published amounts, for tax year 2025, run from $695 to $4,908 for a single person.
How much is the penalty for no health insurance in NJ?
For tax year 2025, the New Jersey Treasury publishes a range of $695 to $4,908 for one uninsured individual and up to $24,540 for a family of five, depending on household income. The state's calculator uses $695 per adult and $347.50 per child under 18 (the 2025 form caps that flat amount at $2,085 per household), or 2.5% of household income above the filing threshold, whichever is higher, capped at the statewide average bronze premium. The Treasury has not published a 2026 range yet, only an estimator.
Is there a penalty for not having health insurance in 2026?
Not from the federal government. HealthCare.gov states that the fee for not having health insurance no longer applies, and it has not been charged since plan year 2018. But according to healthinsurance.org, mandates with penalties are in effect in Massachusetts, New Jersey, California, Rhode Island, and the District of Columbia. If you live in New Jersey, the answer is yes.
How much is the New Jersey health insurance penalty per month?
The state's calculator charges one-twelfth of the annual amount for each month without coverage or an exemption. At the flat rate that is about $58 a month for an adult and about $29 a month for a child, and more if 2.5% of household income above the filing threshold works out higher. Coverage for even one day in a month counts for that whole month.
How long can you go without health insurance in New Jersey before the penalty applies?
Less than three months. Under New Jersey's short gap exemption, code B-1, if you are uncovered for two months in a row you need coverage by the last day of the third month. A gap of three months or longer gets no exemption for any month, and the payment is due for every month without coverage. Only the first gap in a year qualifies.
Who is exempt from the New Jersey health insurance mandate?
Anyone not required to file a New Jersey income tax return is automatically exempt. The Treasury also lists exemptions for coverage that costs more than 8.05% of household income, household income at or below 138% of the federal poverty level, a coverage gap of less than three months, certain religious sects, health care sharing ministries, tribal members, incarceration, living abroad, and hardships such as homelessness, eviction, and bankruptcy. You report the code on Schedule NJ-HCC of Form NJ-1040.
Does a group plan or an ERISA plan count as coverage for the New Jersey mandate?
The New Jersey Treasury's list of minimum essential coverage includes group coverage offered in the small or large group market and, in its words, a self-insured health plan for employees. So real group health coverage satisfies the mandate. What does not count is coverage made up only of excepted benefits, such as stand-alone dental or vision or a specified-disease policy, and accident and fixed indemnity plans are not on the Treasury's list either. Before you enroll, get it in writing that the plan is minimum essential coverage and that you will receive a Form 1095.
Which other states have a health insurance penalty?
Besides New Jersey, California, Massachusetts, Rhode Island, and the District of Columbia charge a penalty for going uninsured, according to healthinsurance.org. Everywhere else, including New York, there is no penalty, because the federal one was set to $0 starting in 2019. The California numbers are on my California health insurance penalty 2026 page.
Thirty minutes on the phone or Zoom, no fee, no hard sell. Bring your age, county, a rough income number, and how you use care. I put the New Jersey doors that fit you side by side, and I show you in writing that what you pick satisfies the mandate. I educate, you decide.
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