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New Jersey News

8/1/11 -Horizon Brief Notes MLR - Average Employee Counts for Medical Loss Ratio (MLR) reporting due August 19, 2011. The Affordable Care Act (ACA) established new rules related to medical loss ratios (MLRs) effective January 1, 2011. The ACA requires health insurance companies to provide premium rebates to enrollees when they do not meet certain MLRs for fully insured business in the individual and small and large group markets. To determine MLRs and potential rebates due, the law requires health insurance companies to obtain the average number of employees during the preceding calendar year for each employer group. To comply with federal requirements, Horizon Blue Cross Blue Shield of New Jersey is collecting from fully insured group customers with 200 and fewer enrollees, their average number of employees in calendar year 2010. The information is due by August 19, 2011.

7/29/11 - AmeriHealth New Jersey launched its newest lower-cost SEH drug option: AmeriHealth New Jersey Custom Rx. This pharmacy product line is now available for all benefits plans in the following lines of business: PPO, POS, POS Plus, HMO, and HMO Plus. Save up to 27% compared to our $0 deductible plans with these lower-cost drug options. Each plan will include an up-front deductible that is applicable to brand drugs only, regardless of formulary. Generic drugs are not applied to the deductible.


7/18/11 - Morristown Medical Center (Morristown) and Overlook Medical Center (Summit) have terminated their agreement with AmeriHealth New Jersey effective July 1, 2011. Although the contract termination is July 1, 2011, New Jersey regulations allow for the terms of the current contract to continue for a four-month period beyond the July 1, 2011, date. Therefore, members may continue to seek services at Morristown Medical Center and Overlook Medical Center on an in-network basis until November 1, 2011.

7/29/11 - AmeriHealth New Jersey has moved! On August 1, 2011, AmeriHealth combined their Mount Laurel and Iselin offices into one central headquarters located in Cranbury, New Jersey — just off of exit 8A on the New Jersey Turnpike. This move allows the entire AmeriHealth New Jersey team to work cohesively from one location and serve the state more effectively. The address of the new building is:

AmeriHealth New Jersey, 259 Prospect Plains Road, Building M, Cranbury, NJ 08512

7/7/11 -  In an effort to address affordability, Horizon Blue Cross Blue Shield of New Jersey is relaxing its rules on moving from one of our standard plans to our Horizon Basic and Essential plan with a rider (Horizon Basic and Essential Exclusive Provider Organization Plus plan [B&E EPO Plus plan]). The current rules limit replacing a standard plan with a B&E EPO Plus plan to the November open enrollment period.