RESOURCE CENTER

Broker Briefs
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Prescription Home Delivery Service is Changing
Eff 8/18/17, members who have Rx coverage through Horizon and use PrimeMail home delivery will have theri scripts filled by Walgreens Mail Service. This transition period may last through the end of the year.
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Molecular and Genomic Testing Program
Beginning 8/1/17, Horizon will implement a new specialty utilization management program in collaboration with eviCore healthcare (eviCore) for certain molecular and genomic diagnostic laboratory testing services.
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Changes to Small Group Out-of-Network Reimbursements
Effective 7/1/17, Horizon updated certain 2017 SG plans to adopt the OON fee schedule of 150% of Medicare's allowance for voluntary OON claims. Horizon reviewed its plans, and per market demands, will improve its OON benefit to customers.
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Horizon and State Agree on Bill that Benefits Members
The legislation as passed allows Horizon BCBSNJ to continuously deliver on its mission to provide affordable, quality products and services to its members. You may be interested in how the revised bill (S-2) differs from the original bill (S-4).
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Prime Specialty Pharmacy
Effective 7/15/17, Prime Therapeutics and Walgreens have integrated to create a collaborativecentral specialty pharmacy. All commercial and Medicare members that use Prime Specialty Pharmacy are affected.
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Recognized for Cyber Security Efforts
This award pays tribute to a select group of 50 organizations that have demonstrated that their security projects and initiatives have created outstanding business value and thought leadership. Horizon accepted the award at the CSO50 Conference.
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Broker News Summer 2017
Quarterly Horizon BCBSNJ newsletter for brokers, inlcuding news on: 2017 Broker Incentive Updates; New Business Sales of Stop Loss Get Primary Nurse; The 2017 NJ Substance Use Disorder Law; and more...
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NJ Substance Use Disorder Law
on 2/15/17, NJ Governor enacted P.L. 2017, Chapter 28, The New Jersey Substance Use Disorder Law, which sets certain coverage requirements for the treatment of substance use disorders and regulates prescriptions of opioid drugs. This law...
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Stop Loss Is Now Packaged with the Primary Nurse Program
Starting June 1, 2017, when a new self-insured group purchases our Stop Loss product, the group will automatically receive access to our successful Primary Nurse Program. The Primary Nurse Program can further mitigate employers’ risk of unexpected co
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Horizon 2017 Broker Incentives for Midsize Groups
For new medical, dental, vision with effective date of 6/1/17 through 8/31/17, for groups with 51-499 eligibles, earn up $45 on Omnia or $10 on all other medical lines, $7 on dental, and $5 on vision (per contract) for fully insured sales.
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Member Incentive for Completing an In-Home Health Assessment
Committed to helping our members lead a healthy lifestyle. That’s why we offer members enrolled in Individual plans or Small Group plans a $40 CVS Pharmacy® gift card for completing a comprehensive health assessment in the comfort of their own home.
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2017 Changes to OMNIA Health Plans for 51+ Groups
Horizon Blue Cross Blue Shield of New Jersey wants to reiterate two changes to OMNIA Health Plans for groups with more than 50 employees. The changes were effective January 1, 2017. These changes were previously communicated via appropriate form and
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51+ Broker-of-Record Letter Templates
There are templates for commission and non-commission scenarios. Your clients should use the appropriate template, entering the required information, and send the letter to Horizon BCBSNJ at the address indicated in the letter.
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HHS Mandates SBC Template Changes
HHS is requring insurers to make changes to the SBC for plans with eff dates of 4/1/17 or later. Horizon will make all necessary changes, as detailed in the attached release...
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Broker News Spring 2017
Quarterly Horizon BCBSNJ newsletter for brokers.
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