Transcript Document
Product Portfolio Strategy Small employer market (two to 50 employees) Welcome Streamlining product portfolio changes due to federal health care reform law. Horizon EPO is a more attractive offering for our customers. Consolidating products to one company enables us to better manage risk. Strategic Purpose First notification was sent to all affected Groups and Brokers on 1/30/13. Groups and Brokers will receive a letter 90 days prior to renewal, starting with 5/1/13 renewals. Groups and Brokers will also receive a 60-day rate notification letter. Notifications Product Mapping Top 5 HMO products being withdrawn: Withdrawn Product Mapped Product HSA HMO ACCESS CDHRX CPT C30/50 D2500 M5000 HSA Advantage EPO CDHRX CPT C30/50 D2500 M5000 no Blue Card Horizon HMO ACCESS COIN 100/80 PL D2500 C30/50 M4500 Advantage EPO 100/80 D2500 C30/50 M4500 no Blue Card HMO ACCESS C25/50 M5000 Advantage EPO 100% C25/50 M5000 no Blue Card Horizon HMO ACCESS COIN 100/50 PL D2500 C30/50 M5000 Advantage EPO 100/50 D2500 C30/50 M5000 no Blue Card Horizon HMO ACCESS COIN 100/80 PL D1000 C20/40 M3000 Advantage EPO 100/80 D1000 C20/40 M3000 no Blue Card Horizon Advantage EPO Key Features What’s changing: Horizon HMO to Horizon Advantage EPO No change in provider network. Same underwriting rules. Split copayments. PCP selection is encouraged, but not required. If PCP is not selected, higher copayment may apply. Benefits are provided for in-network services only. No BlueCard. Prefix: JGV Groups currently within a withdrawn product must complete a signed conversion. Submission Process Groups will automatically convert to the recommended plan if they don’t submit an electronic conversion. Effective 1/1/13: NEW SMG Advantage EPO HAS CDHRX100% D2500 M5000 C30-50 New Horizon Advantage EPO Plan Designs Effective 3/1/13: SMG Advantage EPO 100 M5000 C20-40 SMG Advantage EPO 100 M5000 C25-50 SMG Advantage EPO 100-80 D1000 M3000 C20-40 SMG Advantage EPO 100-80 D2500 M4500 C30-50 SMG Advantage EPO 100-50 D2500 M5000 C30-50 Note: Rx benefits will remain the same but will require submission of an electronic conversion. Additional Product Withdrawals Additional 13 products withdrawn effective 5/1/13. Mapping will be provided under separate cover. Combined membership impacted is 1,000. Questions Thank you! Services and products provided by Horizon Blue Cross Blue Shield of New Jersey or Horizon Healthcare of New Jersey, Inc., each of which is an independent licensee of the Blue Cross and Blue Shield Association. Horizon Healthcare of New Jersey, Inc. is a subsidiary of Horizon Blue Cross Blue Shield of New Jersey. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name, symbols and Making Healthcare Work® are registered marks of Horizon Blue Cross Blue Shield of New Jersey. © 2013 Horizon Blue Cross Blue Shield of New Jersey, Three Penn Plaza East, Newark, New Jersey 07105-2200.