Update: New ONMIA Products Participation and Contribution Requirements

Waiver of minimum participation and minimum employer contribution requirements on the new 7/1/20 Horizon OMNIA Health Plans has been extended to 12/31/20.

Below is the original Brief Notes announcing these new plans with updated waiver highlighted in yellow.


HORIZON BRIEF NOTES

Applies to: Small Employer & Mid-size markets

New OMNIA Health Plans for Small Employers and new Horizon Dental Benefit for Mid-size Employers

Horizon Blue Cross Blue Shield of New Jersey (Horizon BCBSNJ) is pleased to announce new Gold and Silver OMNIA Health Plan options for small employers, and new Horizon Dental benefits for mid-size employers, both effective July 1, 2020.

New OMNIA Health Plan Options for Small Employers
The new OMNIA Gold HSA BlueCard plan includes the flexibility of a Health Savings Account (HSA) with out-of-state BlueCard® coverage. Your small business clients will continue to enjoy low costs with leading providers in New Jersey. Members will incur no additional costs once their deductible is met when they use OMNIA Tier 1 doctors, hospitals and other health care professionals.

The new OMNIA Silver Value plan is our most affordable Silver plan. Your clients will continue to enjoy competitive prices, access to the broad Horizon Managed Care Network, and comprehensive benefits with low copays and no deductible when using OMNIA Tier 1 Primary Care Physicians.

Minimum participation and minimum employer contribution requirements do not apply for applications received through December 31, 2020 (was originally November 14, 2020) for OMNIA Gold HSA BlueCard or OMNIA Silver Value plans. This applies regardless of whether the OMNIA Gold HSA BlueCard plan or the OMNIA Silver Value plan is the sole plan offering or one option among multiple plan offerings.

These new options are available now through Horizon BCBSNJ’s Broker Portal and HealthConnect for July 1, 2020 and later renewals or new business opportunities. Updated sales enablement materials will soon be available to help you educate your clients on these new offerings.

New Horizon Dental Benefit for Mid-Size Employers

Effective July 1, 2020, new business sales of Horizon Dental Option, Horizon PPO, Horizon Healthy Smiles and Horizon Healthy Smiles Plus plans to pooled groups of 51 to 99 employees will automatically include a 50% to $1,500 lifetime maximum orthodontic benefit for dependents up to age 19 at no additional charge. Horizon Dental Choice and TotalCare plans do not include this new benefit.

Additionally, benefit-waiting periods will no longer apply for new business groups of 51 to 499 employees.