Horizon BCBSNJ Small Group MLR Refund

Horizon BCBSNJ has advised that there will be a refund for certain Small Groups as part of the state mandated minimum loss ratio provision as follows: 

  • All non HMO business enrolled with Horizon for the 2019 calendar year will receive the refund.
  • The overall amount of the refund is 27.7M and on average amounts to approximately $1,100 dollars a group.
  • These checks should be arriving this week to your clients.

Additionally Horizon has noted that in 2019, and this year as well, they have had very competitive rates in the market. The refund is due to their continued success with their OMNIA strategy, Value Based Care and ability to control cost in a superior way. They now have over 50% of their small employer business in an OMNIA product.

Click here for a full FAQ on Horizon’s Small Group MLR Refund.