Horizon is the local Blue Cross and Blue Shield Plan for the state of New Jersey and offers plans ranging from traditional indemnity plans to HMO, POS, PPO, and MSA plans. Horizon also offers dental coverage along with behavioral health through Magellan Behavioral Health.
Horizon covers more than 600,000 subscribers across individuals, small employers, and large groups. They offer flexible deductible and coinsurance options as well as various co pay structures.
Some of the better selling plans in 2010 and 2011 have been Horizon NG HMO, Horizon Direct Access POS, and Horizons HMO product. With the Horizon NG HMO, you are able to visit any doctors within the network, without a referral, hence the NG name stands for Non-gatekeeper. In addition with the structure of the plan, employers may choose to actually offer the product in a consumer-directed health plan model with a high-deductible. As such members still get the same integrity of the plan, though the first-dollar coverage is removed. As such employers may couple these plans with HRAs or health reimbursement arrangements, or HSAs or health savings accounts. The Horizon Direct Access POS products recently have eroded from a medical loss ratio perspective and as such have not been very well priced in the last few quarters of 2010, rolling in to 2011. These plans work similarly to a PPO, in that you may visit in-network doctors without a referral (direct access meaning no referrals) and you can also go out of network. The more flexibility Horizon gives you with products and out-of-network coverage, the more expensive the product. It is not uncommon now in 2011 to see plans in New Jersey where a single rate is approaching $1,000 per month.
After an original consideration to switch to a for-profit status in 2005, Horizon withdrew its consideration, and today remains a non-profit organization.
