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Horizon NJ

You will need the forms that start with a plus sign (+) to process new business.

 Horizon NJ Spanish Forms

  • + Horizon NJ Small Employer Group Application 2022
  • + Horizon NJ Small Group Employee Enrollment-Change Form
  • + Horizon NJ Small Group Master Application
  • BenefitWallet HSA Employer Setup Form
  • Horizon Health Plus Plan SEHPP Bundle
  • Horizon NJ Confirmation of HSA Selection
  • Horizon NJ Conversion Request Form
  • Horizon NJ Declaration of Understanding
  • Horizon NJ Deductible Carry Over Form
  • Horizon NJ Group Automatic Pay Plan Application
  • Horizon NJ HHPlus Plan with Medical_SEHP and SEHP Bundle
  • Horizon NJ HMO POS Direct Access Medical Claim Form
  • Horizon NJ HSA My Way Plan Design Guide
  • Horizon NJ Melon Set Up Document
  • Horizon NJ Prime Rx Mail Order Form
  • Horizon NJ Prime Therapeutics Rx Claim Form
  • Horizon NJ Request Of Continuance For Disabled Dependent
  • Horizon NJ Small Group Employer Certification
  • Horizon NJ Small Group Waiver of Coverage

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