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New Jersey News

Member Healthplans NJ

Brokers, as you know Affiliated Physicians & Employers Health Plan (APEHP) has transitioned to their new name Members Health Plan.  All materials will carry this brand when you transition to the Aetna Platform or if you have enrolled as a new group effective 7/1/2019. With the transition to a fresh name and a new brand, there are some additional Billing/Remittance changes that you should be aware of. Please update your records to reflect the items attached in the PDF below.

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horizon BCBS

 

Brokers, renewal is a great time to look at Horizon’s OMNIA suite of products now available with BlueCard as well as the New Voluntary Dental, Vision or SEHPP Ancillary Bundle of Products as options for your Small Groups!  Marketing materials are linked below.  Also, remember that the conversion deadline for 7/15/19 renewing groups or off anniversary conversions is Monday 7/8/19 at 12:00 noon. Any groups that are submitted after this deadline will be moved to a 8/15/19 effective date.  Horizon has determined that if a group is accepting their existing ACA plan renewal, no paperwork is necessary.

Conversions without all required documentation or submitted after deadline face the risk of losing their requested conversion date and being moved to the next month. This is for ALL PRE-ACA to ACA CONVERSIONS regardless if they have sent in their certification previously to Horizon and were advised they could renew as is by Small Group certification. All paperwork should be emailed to TeamFarronNJ@fnainsurance.com or FNATeamFasanella@fnainsurance.com. ; Conversion paperwork should not be send to Horizon’s certification department.

horizon BCBS

 

Horizon BCBS of New Jersey is sharing new information with their valued broker partners to aid in servicing consumers with the most up to date products and services available. Click below to read more. 

 

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Horizon BCBS NJ SM for web

 

Horizon Blue Cross Blue Shield of New Jersey will transition the administrative and clinical management of the Horizon Behavioral Health Program from Beacon Health Options to Horizon BCBSNJ internal operations. Horizon Medicare Advantage plans will change on or about January 1, 2020. All other fully insured and self-insured plans will change on or about April 1, 2020. Read more below on the changes to the Management of the Hoirzon Behavioral Health Progam

 

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AmeriHealth Logo2012sm

Effective July 1, 2019, in addition to Children's Hospital of Philadelphia, the Local Value Network will offer  Summit Medical Group for all segments and Penn Medicine for Small and Large group segments only. With this addition, the Local Value Network now has over 90% overlap when compared to the Regional Preferred Network.  Click below for the full update from AmeriHealth.

PDF icon2SM Click here to download the full pdf document