Without warning, Horizon Blue Cross dropped its OMNIA plan onto unsuspecting New Jersey consumers, doctors and hospitals. As the largest health insurer in the state, Horizon is fighting hard in court to get its way, but the insurer has gone too far with its controversial OMNIA plan. OMNIA dangerously undermines health care delivery in New Jersey by punishing some of the state's best and highest rated hospitals, including most Catholic institutions, and steering consumers to specific hospitals. But, you can fight back!

Horizon opposes transparency. Why?

  • Horizon's OMNIA plan set up a two tiered system that rewarded some hospitals with Tier 1 designations and penalized others with Tier 2.
  • Horizon's tier scheme gives preference to the state's largest hospital systems while excluding some of NJ's highest-rated and reasonably priced hospitals.
  • Despite demands from elected officials and the media, Horizon still refuses to divulge its mysterious selection process.
  • There was no public process or known criteria by which hospitals and physicians were assigned to a tier, nor is there any public path to move to another tier.

Horizon's controversial OMNIA hurts consumers!

  • Since so many hospitals and doctors were excluded from Tier 1, patients may not have access to health care unless they are willing to pay more or travel long distances.
  • Many patients may be forced to find a new doctor or hospital - even in the middle of treatment - or pay a much higher copay.
  • The exclusion of so many doctors and hospitals creates a critical health care gap for patients and families in many at-risk communities.

There is a solution that protects patients, their families and communities!

  • Once controversial plans such as OMNIA are fully implemented, any negative impact to our health care system cannot easily be undone.
  • Freezing enrollment into any tiered health care plan will provide the opportunity to get it right - and avoid placing further patients and communities at risk.
  • This freeze will give the New Jersey Legislature time to create guidelines for tiered plans that will ensure transparency, access to care for all patients, and the establishment of provider criteria that are based on true value and quality of care
  • Patients who are already enrolled in OMNIA can maintain their enrollment while the state creates and codifies these guidelines through legislation.
Join Us and Stay Informed on How You Can Protect Your Health Care!

Featured News Article

EVER SINCE Horizon Blue Cross and Blue Shield of New Jersey classified state hospitals as Tier 1 and Tier 2 last fall, critics have wondered about the company's criteria for doing so

That apparently will remain unknown after a state appeals court last week denied opponents of the plan access to the details of Horizon reports and other information explaining why it classified the hospitals the way it did when it launched its Omnia health plan.

We understand that as a private company, Horizon is not held to the same disclosure standards as a public agency. At the same time, the Omnia plan has drawn so much criticism from hospitals left out of the Tier 1 grouping, Horizon could benefit from complete transparency. More important so could the public.

Horizon created its Omnia plan as part of an alliance with several large hospital systems. A key part of the plan was the creation of a two-tiered system of in-network hospitals. Patients benefit from using Tier 1 hospitals by paying lower costs. Hospitals in the top grouping benefit from an increase in patients.

Continue Reading

read more articles