![]() ![]() The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross Blue Shield Association. The Benefit of Blue℠ is a service mark of the Blue Cross Blue Shield Association. All are independent licensees of the Blue Cross Blue Shield Association. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. Medicare Supplement plans are provided by Horizon Insurance Company. ![]() Products are provided by HIC and/or Horizon NJ Health. Enrollment in HIC Medicare products and/or Horizon NJ TotalCare (HMO D-SNP) depends on contract renewal. Horizon NJ TotalCare (HMO D-SNP) is an HMO Medicare Advantage Dual Eligible Special Needs plan with a Medicare contract and a contract with the State of New Jersey Medicaid Program. ![]() Horizon Insurance Company ("HIC") has a Medicare contract to offer HMO, HMO-POS, PPO and Part D Medicare plans, including group-Medicare Advantage plans and group Part D Prescription Drug plans. The health impact study concludes that Horizon’s restructuring would maintain the policyholder benefits associated with Horizon’s unique status in the New Jersey market, including explicit Horizon commitments to both its statutory mission and charitable status.Eligibility Information & Enrollment Instructions Specifically, the health impact study reviews Horizon’s commitments made in the application, focuses on areas where the restructuring may have an impact on policyholders, and considers areas that will require ongoing department monitoring. The health impact study prepared for the department by Manatt, Phelps & Phillips, LLP and Manatt Health, which may be found on the department website, examines the statutory mission and charitable status issues regarding Horizon’s restructuring and such restructuring’s potential impact on policyholders and the public. The department determined that a voluntary health impact study, optional under the law, would be valuable to its evaluation. and Rudmose & Noller Advisors, LLC to assist the department in evaluating Horizon’s application, as permitted under the law. The department engaged Manatt, Phelps & Phillips, LLP and Manatt Health Oliver Wyman Actuarial Consulting, Inc. “It is important to note that under the law, the company must maintain its mission as a charitable and benevolent institution, and the state Attorney General has confirmed that any nonprofit mutual holding company formed under the law remains subject to its oversight,” Commissioner Caride said in a statement announcing the decision. DOBI based its decision on a review of the application, supporting documentation submitted by Horizon (also known as Horizon Healthcare Services, Inc.), as well as the public testimony from three public hearings, written public comments, and the entire record of the proceedings and analyses by consultants engaged by the department. The department determined that the reorganization and mutualization of Horizon met the criteria under state law for approval. The application was approved under criteria outlined in state law, which says the commissioner shall approve a plan of mutualization and reorganization unless that plan is contrary to law would be detrimental to the safety or soundness of the proposed reorganized insurer and insurance company subsidiaries of the proposed mutual holding company or does not benefit the interests of the policyholders of the health service corporation or treats them inequitably. “We appreciate the complete effort that the department invested in evaluating the application and are excited to turn our focus to delivering the benefits that this reorganization will deliver to our members, customers and New Jersey’s healthcare system,” the Horizon statement said. In a statement issued after the DOBI decision was announced on Tuesday evening, Horizon said the decision by State Commissioner of Banking and Insurance Marlene Caride “preserves Horizon’s historic not-for-profit mission while giving the company added flexibility to adapt and better serve our members by improving healthcare quality, convenience and affordability.” 1, is subject to 11 conditions imposed by the department to ensure that Horizon operates prospectively in a manner consistent with the objectives of state law, including that Horizon act in the interest of policyholders and maintain financially safe and sound insurance subsidiaries. The New Jersey Department of Banking and Insurance (DOBI) has approved an application by Horizon Blue Cross Blue Shield of New Jersey to reorganize its corporate structure as a nonprofit mutual holding company. ![]()
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