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Layoffs are due at Horizon Blue Cross Blue Shield of New Jersey, which will cut 242 jobs, according to a WARN Notice filed with the Department of Labor & Workforce Development. 

The state’s largest health insurer, Horizon BCBS NJ posted the layoffs in January with an effective date of April 26, 2026.  

In a statement provided to NJBIZ, the company cited the changing climate for not-for-profit health insurers. Additionally, Horizon BCBS NJ said it notified employees last November of an impending restructuring due in early 2026 that would eliminate approximately 300 positions.

“Earlier this week, most of the impacted employees were informed that their positions were eliminated as part of this restructuring,” according to the statement. “When taken together with other targeted actions in 2025, Horizon has reduced our workforce by roughly 8%. We do not take workforce reductions lightly.

“Employees whose positions were eliminated were treated with fairness and respect and will receive a generous separation package.”

Evolving landscape

As of Dec. 31, 2025, Horizon said it insures approximately 3.7 million New Jerseyans.

A September 2025 report from HealthScape Advisors found regional, nonprofit health plans recorded a 71% operating loss in 2024. And that “the forces causing these disproportionate operating losses will only accelerate in the days ahead.” Additionally, Becker’s Payer Issues noted regional and BCBS plans reported higher administrative loss ratios and medical loss ratios compared with national peers.

Around the U.S., other regional BCBS operators have also announced cuts. The figure is about 90 in Idaho. Meanwhile last fall, BCBS of Massachusetts offered voluntary buyouts to about 750 employees.

“Horizon, like most not-for-profit health insurers, is facing unprecedented financial challenges due largely to higher medical costs and utilization across all lines of business,” Horizon BCBS NJ said in its statement. “Over the past three years we have taken proactive steps to control rising health care costs, including reducing our own operating costs by $275 million. Nonetheless, our current cost structure is simply not sustainable in this environment and we have a responsibility to our customers and members to ensure the long-term financial strength of the Company.”

Last November, Horizon agreed to pay $100 million to the state of New Jersey to settle allegations “it fraudulently secured a 2020 contract to administer New Jersey’s employee health benefit programs and overcharged the state.” 

In December, Horizon announced St. Joseph’s Health system will move out of network, effective March 1, 2026. That change will impact St. Joseph’s University Medical Center in Paterson and St. Joseph’s Wayne Medical Center in Wayne, as well as hundreds of providers within the Paterson-based system’s medical group.