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Mayor James Solomon announced Tuesday that Jersey City hired an independent firm to conduct a comprehensive audit of health insurance claims. The review will examine claims paid by Horizon Blue Cross Blue Shield of New Jersey during the company’s tenure as third-party health insurance administrator for the city.

Jersey City officials said the audit will cover all claims processed under the prior contract. The efforts aim to determine whether the city overpaid for health care services.

Under the terms of its agreement with the city, Horizon is legally required to cooperate with the audit. It must also repay any funds identified as improperly paid.

“The previous administration underbudgeted and delayed $52 million in health care bills and never once asked where all that money was going,” Solomon said. “We believe there is significant money owed to Jersey City taxpayers. We intend to get it back.

“The previous administration paid whatever Horizon billed, year after year, with no scrutiny and no audit. That era of financial indifference is over.”

Moving from Horizon to Aetna

The audit is part of an effort led by Finance Director William Viqueira. Solomon appointed Viqueira after his more than three decades in public and private finance, including serving as CFO and treasurer of NJ Transit. City officials have tasked him with strengthening financial oversight and professionalizing the city’s fiscal operations.

The review also comes after the city transitioned its employee health plan from Horizon to Aetna as its health insurance administrator, earlier this year. Solomon projected that move will reduce spending by about $30 million annually while maintaining or improving benefits for municipal employees.

Officials said the audit will examine claims submitted under the prior Horizon contract. They expect to complete the review within roughly two months.

In a statement to NJBIZ, Horizon responded:

“Since our founding nearly 100 years ago, Horizon has had a long and positive history of partnering with employers across New Jersey. Those partnerships, built on a hard-earned foundation of integrity and trust, have provided best-in-class service and unsurpassed access to high quality health care for millions of public and private employees while saving them, and their employers, billions of dollars.

“The claims processed for Jersey City were paid according to the contracts in place with the providers who filed them.”

The Solomon administration said it plans to release the audit findings once it finishes the review, including any recovered funds.