New Jersey Expands Newborn Coverage Mandate for Insured Plans to 90 Days

May 4, 2026

New Jersey has enacted an updated newborn coverage mandate that extends the period of automatic newborn coverage from 60 days to 90 days under certain health plans. This change reflects New Jersey’s continued effort to expand dependent eligibility protections—but its applicability varies significantly based on funding arrangement. Here’s what you need to know:

What This Means for Fully Insured Plans

For fully insured plans in New Jersey issued or renewed on or after March 8, 2026, the law requires:

• Automatic coverage of newborns under their parents’ health insurance for the first 90 days following birth (an increase from the previous 60-day rule effective in 2018)
• Coverage applies regardless of whether the child has been formally enrolled
• Coverage terminates at 90 days unless the parent completes enrollment
• If contributions are required, notice and premium payment must be made within the 90-day period to continue coverage

Fully insured carriers will be obligated to automatically update all systems and plan materials to reflect the new changes. Here are some additional considerations for insured plans:

• The mandate does not apply to newborns of dependent children
• Coordination of Benefits (COB) rules apply, including the standard birthday rule when both parents have coverage
• The mandate does not apply to public employee benefit programs
• For calendar year plans, this change will generally take effect January 1, 2027

Self-Funded Plans Are Not Subject to NJ Mandate

This mandate does not apply to self-insured health plans due to federal preemption under the Employee Retirement Income Security Act (ERISA). Self-insured plan sponsors may adopt the NJ requirements and can also choose to select a different newborn coverage duration (e.g., 31 days, 60 days, etc.)  Carriers/third-party administrators need confirmation of the employer’s election to opt in, stop-loss/reinsurance would need to be notified and approved, and a summary for employees regarding this benefit will need to be provided.

Interaction with Federal Requirements

Note that under federal law, there is no requirement for automatic coverage (e.g., 30, 60, or 90 days) absent enrollment. Both self-insured and fully insured plans continue to operate under federal HIPAA special enrollment rules, which provide a required 30-day enrollment window for newborns following birth. If enrollment is completed within that timeframe, coverage must be retroactive to the date of birth. If enrollment is not completed within the 30-day special enrollment period, then HIPAA does not require the plan to provide coverage. The New Jersey mandate also operates alongside the federal Newborns’ and Mothers’ Health Protection Act (NMHPA), which generally requires most plans to provide coverage for minimum hospital stays (48 hours for vaginal delivery and 96 hours for cesarean section), but does not require automatic coverage for newborns who are not otherwise covered under the plan.