Horizon calls its 6% premium increase 'proof' tiers work


Horizon Blue Cross Blue Shield of New Jersey declared its Omnia ACA plans — which inspired a string of lawsuits in 2015 — boast some of the lowest premium rate increases nationally next year, reports The American Journal of Managed Care.

HHS' report on ACA marketplace trends released Monday showed premiums for plans on federal and state exchanges in 2017 would rise an average 25 percent and 22 percent, respectively.

By contrast, Horizon raised Omnia plans' premium rates an average 6.19 percent for bronze plans, 5.37 percent for silver plans and 5.4 percent for silver plans with health savings accounts.

Horizon's only competitor offering gold plans on New Jersey's exchange, AmeriHealth, increased its premium an average 53.3 percent. 

Horizon launched Omnia in September 2015 to combat the state's historically high premiums. Omnia is both a tiered health plan and a population health initiative designed to give consumers discounted coverage if policyholders use Tier 1 — or preferred — hospitals and providers for services. The plans target largely individual and small business group markets.

Horizon's tiered plans sparked outrage from some healthcare providers relegated to Tier 2 status, many of which argued their service quality was equal or superior to hospitals Horizon made preferred providers. Seven New Jersey hospitals filed suit against Horizon in December 2015, alleging the Tier 2 designation unfairly harmed the hospitals' reputations and business volumes. The state Supreme Court dismissed the lawsuit Oct. 1.

As of Oct. 24, approximately 280,000 people were enrolled in Omnia plans across all market segments, including 163,000 in the individual market.

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