Horizon Individual enrollment numbers up in ACA marketplace

Horizon Blue Cross Blue Shield of New Jersey released the latest enrollment numbers for its individual coverage options in the Affordable Care Act marketplace on Thursday.Horizon Blue Cross Blue Shield of New Jersey released the latest enrollment numbers for its individual coverage options in the Affordable Care Act marketplace on Thursday.

A total of 27,540 previously uninsured enrollees chose Horizon plans, bringing the total number of individuals to 276,753.

A majority of the members, more than 238,000, chose the OMNIA health plan.

Last year, the first year of the OMNIA plan, Horizon saw just over 245,000 enrollees, and anticipated exceeding 256,000 by the end of 2016.

Some new enrollees this year came from the loss of two health insurers in the state’s insurance exchange — UnitedHealthcare Oxford and the co-op Health Republic of New Jersey, which has been liquidated by the state’s Department of Banking and Insurance.

Horizon also has seen a demand for the OMNIA product in the employer market.

There were a total of 12,265 enrollees in the group market, a majority of which were small employer groups, totaling 10,847. The remainder were midsize groups.

In light of Horizon’s recent battle with Gov. Chris Christie, who has taken aim at the insurer’s large pockets as a potential resource for the state’s battle against an opioid addiction crisis, Horizon also included its financial contributions in the statement accompanying its enrollment numbers.

• Horizon paid $205 million in state taxes and $330 million in federal taxes in 2016. Horizon is a tax-paying not-for-profit New Jersey company with 5,500 employees.
• In 2016, Horizon had a net income of $84.6 million on revenues of $12.2 billion (a 0.7 percent margin). In 2015, Horizon’s net income was $106.7 million on $11.5 billion in revenues (a 0.9 percent margin).
• Horizon spent over $300 million in 2015 and 2016 treating policyholders’ substance abuse and addiction illness.

“The results of open enrollment 2017 demonstrate that the demand for high-quality, affordable health insurance continues to grow. OMNIA was designed to meet that need with a lower premium, access to our full network of providers and the option to reduce out-of-pocket expenses by choosing certain doctors and hospitals,” said Robert Marino, Horizon’s chairman and CEO. “The cost of care drives the cost of insurance, and Horizon is committed to collaborating with doctors, hospitals and other health care providers that share our goals of improving quality outcomes, reducing costs and delivering a better patient experience. 

“Unfortunately, not everyone shares those goals, and I am hopeful that Trenton will help by tackling surprise medical billing and out-of-network price gouging and dealing with this billion-dollar problem once and for all.” 

Some other enrollment statistics:

• OMNIA enrollees who chose a bronze, silver or silver health savings account plan: 94 percent.
• Bronze: 17 percent; Silver: 46 percent; Silver HSA: 31 percent; Gold: 6 percent.
• Previously uninsured enrollees: Hispanic, 16 percent; African-American, 14 percent; Asian, 14 percent.
• Majority of enrollees are in Bergen, Middlesex and Monmouth counties.

Here is the breakdown per county, provided by Horizon:

• Bergen: 33,809 members.
• Middlesex: 23,035.
• Monmouth: 20,011.
• Essex: 18,541.
• Morris: 17,336.
• Hudson: 17,316.
• Ocean: 16,808.
• Union: 13,831.
• Passaic: 13,004.
• Somerset: 10,180.
• Mercer: 8,528.
• Camden: 7,671.
• Burlington: 6,975.
• Hunterdon: 6,264.
• Atlantic: 5,606.
• Sussex: 5,026.
• Gloucester: 4,480.
• Cape May: 3,276.
• Warren: 3,177.
• Cumberland: 2,212.
• Salem: 992.