Horizon has announced a change to their product portfolio and have elected to withdraw their HMO plans from the Individual and Small Employer Health Benefits Plan (SEH) markets. The New Jersey Department of Banking and Insurance (DOBI) has given its approval for Horizon to withdraw its HMO plans from the markets under the authority of N.J.S.A 17B:27A-6 and N.J.A.C. 11:20-18.5 (for Individual plans) and N.J.S.A. 17B:27A–23e and N.J.A.C. 11:21-16 (for small employer plans).
This withdrawal will affect Individual members enrolled in the Horizon HMO Gold plan, and group clients and their employees who are enrolled in the Horizon HMO Platinum plan. Brokers with affected small group clients, and those affected small group clients, will receive notices from Horizon via certified mail, as per DOBI regulations. A sample notice can be viewed here.
Individual members enrolled in the Horizon HMO Gold plan can remain in their coverage until December 31, 2022. Group customers that offer the Horizon HMO Platinum plan can remain in their coverage until their first group anniversary on or after January 1, 2023, at which time the Horizon HMO Platinum plan will be terminated.
The Horizon HMO Gold plan will not be available for sale in the Individual market as of January 1, 2023. The Horizon HMO Platinum plan is not available for sale in the small employer market as of June 24, 2022. . As always if you have any questions about how this impacts your coverage, if at all please reach out to your Total Benefit Solutions, Inc health insurance experts at (215)355-2121.