Horizon joins multistate network in expanding Medicare Advantage offering

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The state’s largest insurer is convinced it can make waves in a crowded pool that includes heavyweights like Aetna and United.

By tapping into a new, 31-state network of Blue Cross plans, Horizon Blue Cross Blue Shield of New Jersey is poised to expand sales of its Medicare Advantage program to employers seeking Medicare Advantage products for their retirees that offer enhanced coverage compared with traditional Medicare. Joining this multistate Blue Cross network enables Horizon to compete with health insurers like Aetna and UnitedHealthcare that operate nationwide and already provide multistate Medicare Advantage products to employers.

Horizon will be able to market to New Jersey employers a Medicare Advantage plan that covers retirees whether they remain in New Jersey or move to one of the states in the network, including Florida, the Carolinas, Texas and California. The insurer has 3.6 million members in New Jersey and about 98,000 Medicare customers, including employer groups, individuals and prescription drug plans.

The national Blue Cross system started its network sharing plan for Medicare Advantage in 2010 and it now covers a large enough cross section of the country to enable Horizon to “offer it as a viable alternative for our group customers,” said Peter Morey, director of product innovation and marketing at Horizon.

Horizon is rolling out a new Medicare Blue Group PPO to its group, or employer division; the company also markets Medicare Advantage plans directly to individuals.

Gayle Adams, president of UnitedHealthcare Medicare and Retirement Group Retiree Services, said the company has offered Medicare Advantage for two decades and has 10 million Medicare customers nationwide, including 10,000 members who live in New Jersey, and 75,000 group retiree Medicare Advantage members who live elsewhere, but retired from New Jersey companies.

She said UnitedHealthcare is continuing to invest in Medicare products. “Employers are interested in group retiree Medicare Advantage plans because they help employers manage their retiree health care dollars while honoring their commitment to offering innovative and quality health care coverage.”

Richard A. Frommeyer, Aetna’s head of group Medicare, said the company’s Medicare Advantage business covers hundreds of thousands of retirees nationwide. He said Aetna provides a strong clinical care management program, with nurses and doctors on the staff at Aetna overseeing care and who “encourage our seniors to be very proactive in engaging with their primary care physicians and specialists to stay as healthy as they can.”

He said 2012 was a “steady” year for Medicare Advantage, with employers waiting on the Supreme Court decision on the Affordable Care Act, so “we think 2014 will be a good year, and we continue to be very optimistic about this business.”

Laura Christiner, manager of product development at Horizon, said there is plenty of room for Medicare Advantage plans to grow in New Jersey. While nationwide 26 percent of Medicare recipients are in a Medicare Advantage plan, that figure is about 15 percent for New Jersey. She said Horizon estimates it could enroll up more than 4,000 retirees in its new Medicare Advantage PPO in 2013, with new enrollees estimated at between 10,000 and 13,000 in 2014 when the program is fully ramped up.