Employer 2-50
Health Care Plans for Employers with 2-50 Eligible Employees (Eligible employees work 25+ hrs./wk.) Because no two horizons are the same, Horizon Blue Cross Blue Shield of New Jersey offers a full range of coverage options for you and your employees. Horizon Advantage Plans
Lower premiums. Flexible coverage. Increased employee cost sharing. Using in-network services results in lower out-of-pocket costs. Using non-network services results in increased employee cost sharing. The Preferred Provider Organization (PPO) health plan offers the freedom for members to use any of the more than 17,000 participating physicians, hospitals and other health care professionals in the Horizon Traditional Network. The Direct Access health plans offer the freedom for members to use any of the over 10,000 participating physicians, hospitals and other health care professionals in the Horizon Managed Care Network - without referrals. The following are the Horizon Advantage Direct Access and Horizon Advantage Preferred Provider Organization benefit designs and links to the corresponding Benefit Highlights that detail the available copayment, deductible and coinsurance options...
Horizon MyWaySM HSA
Horizon MyWay HSA is a consumer-driven health plan that combines a qualified high-deductible health plan and a Health Savings Account (HSA). The health plan can either be a Horizon PPO or Horizon Direct Access plan. Funds in the HSA can be used to pay for eligible medical expenses not covered by the health plan. Unused HSA funds roll over to the next year, allowing members to save for future health care expenses. Learn more... Horizon BCBSNJ PPO
Horizon PPO is our Preferred Provider Organization plan. Your employees have the choice of more than 24,800 physicians and specialists in our Horizon PPO Network and 73 hospitals in more than 82 locations. If an employee uses our network physicians, he or she receives a higher level of coverage; if an employee chooses an out-of-network physician or hospital, the employee pays a higher share of the costs.
Horizon BCBSNJ POS
You and your employees have the freedom to use the Horizon Managed Care Network of physicians or choose physicians and hospitals outside the network. In-network employees select a Primary Care Physician (PCP) to coordinate their needs. By going out-of-network, employees may encounter higher out-of-pocket expenses and more paperwork.
Horizon BCBSNJ Basic Health Plan A*
This is a fee-for-service health benefits plan under which you and your employees can receive limited (30 inpatient days per year) hospital coverage at a lower cost than other, more comprehensive health benefits plans. This plan is for individuals who want the security of basic hospital coverage in case of unforeseen illness or injury.
NOTE: Some coverage offered under our other traditional plans is not covered by Plan A. Please review your benefits certificate carefully. Horizon HMO Access
Horizon HMO Access provides direct access to network specialists without a referral. Employees select a Primary Care Physician (PCP) from our Horizon Managed Care Network of more than 17,800 doctors and specialists in the state and enjoy the freedom to coordinate their needs without a referral. Members may not self-refer to PCP-type providers; they must use their selected PCP. (Horizon HMO is issued by Horizon Healthcare of New Jersey, Inc., a subsidiary of Horizon Healthcare Services, Inc.) Horizon HMO Access Coinsurance
This health maintenance organization plan allows members to access any primary care provider and any specialist provider without a referral. In addition, selecting a Primary Care Physician is optional. A Primary Care Physician may still coordinate medical care, but members do not need a referral to access specialists. Members in these plans pay a copayment for services received in the practitioner's office, and are subject to deductible and coinsurance for most services received outside of the practitioner's office. The Horizon Managed Care Network includes more than 10,000 participating providers. Members have the security of comprehensive coverage, and virtually no claim forms to fill out - all at a competitive monthly rate. Horizon BCBSNJ offers an HMO Access Coinsurance plan to provide your clients with comprehensive health benefits. This is a no-referral plan.
Horizon BCBSNJ HMO*
This Managed Care plan gives your employees the security of low out-of-pocket expenses, comprehensive coverage, and virtually no claim forms to fill out; all at a competitive monthly rate. Employees choose a Primary Care Physician (PCP) from our Horizon Managed Care Network of more than 17,800 doctors and specialists in the state. PCPs manage medical care and refer employees to specialists and hospitals. (*Horizon HMO is issued by Horizon Healthcare of New Jersey, a subsidiary of Horizon Healthcare Service, Inc.)
Horizon BCBSNJ Pharmacy Services
Horizon BCBSNJ's Pharmacy Services include a prescription ID card program with low cost sharing for generic and brand name drugs at participating pharmacies or through mail-order service. More than 98 percent of New Jersey's pharmacies participate in the program. *The information on these pages is a summary of the benefits coverage, terms, conditions, and exclusions contained in Horizon Healthcare Services policies/contracts. In the event of a conflict between the information contained on these pages and the actual terms of a policy or contract, the terms of the policy or contract will prevail.
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