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HorizonBlue-Logo-Updated-Jan15 2013

 

 

 

Horizon Conversion Request

Please note conversion deadline for 10/28/15 renewing groups is Wednesday 10/21/15 at 12:00 noon. Horizon has determined that if a group with a 2015 renewal date is accepting their existing pre-ACA or ACA plan renewal, no paperwork is necessary.  Only if a group is converting to a completely different ACA plan alternative or if they are moving from a pre-ACA plan to an ACA plan would conversion paperwork be necessary (including a signed conversion form and copy of quote for new plan design).  

NOTE: No changes can be made to pre-ACA plans.  Groups must accept their pre-ACA renewal as is or move to an ACA plan.  Members of a pre-ACA group can only move between existing pre-ACA subgroups with an open enrollment application at renewal.

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Horizon BCBS Conversion Request Form