Know The Facts
Fact #1
HORIZON'S OMNIA: WILL PENALIZE YOU TO STAY WITH YOUR PREFERRED DOCTORS AND HOSPITAL.
If you join OMNIA and your hospital and/or doctor is assigned to "Tier 2" rather than "Tier 1," you will be forced to pay far more in copays and deductibles than you would at a Tier 1 provider – even if you are already in the middle of treatment. This is a financial penalty through which Horizon's OMNIA plan effectively ignores your wishes, and also ignores some of NJ’s best hospitals, hospitals that are renowned for their quality care, lower costs, and patient preference. Don't let an insurance company dictate your healthcare decisions. Say NO to Horizon’s OMNIA.
Fact #2
HORIZON'S OMNIA: DESIGNED TO EFFECT A WIDE SWEEPING SHIFT OF PATIENTS FROM THEIR CHOICE HOSPITALS AND DOCTORS TO TIER 1 HOSPITALS AND DOCTORS.
Through economic incentives such as Tier 1’s zero copays and deductibles, OMNIA is designed to shift patients from any Tier 2 hospital of choice to those that Horizon has opted to designate as OMNIA Tier 1. Horizon already controls more than 43% of the entire New Jersey health insurance market. The growth of OMNIA will increase that share, reducing competition for quality and pricing, further limiting your choice for healthcare. As excessive Tier 2 copays and deductibles push patients to an inevitable transition to OMNIA’s Tier 1, healthcare will be dictated by Horizon, rather than by patients. And Horizon’s already substantial political "clout" will become unstoppable.
Fact #3
HORIZON'S OMNIA: NO TRANSPARENCY IN HOSPITAL SELECTION.
We have no objection to tiered networks. But did Horizon use any comparative metrics to select its Tier 1 hospitals? If it did, it has not released any findings. The factors and criteria used to profile providers and place them in tiers within a network should be transparent to hospitals, to regulators, and to you as the consumer. How can you trust Horizon’s OMNIA tier assignments if its selection methodology remains shrouded in mystery, and hospitals that you know and trust were not even approached for Tier 1 evaluation?
Fact #4
HORIZON'S OMNIA: NJ STATE SENATORS WANT THE ATTORNEY GENERAL TO REVIEW OMNIA.
Many members of the New Jersey State Senate and Assembly want the Attorney General to review OMNIA's plan design and participants — they're not convinced that OMNIA is in the best interest of consumers. Senator Nia Gill stated publicly that OMNIA "has the earmarks of being a potential monopoly, as well as serious consumer protection issues, and that this needs more scrutiny, transparency and oversight." At best, we find this worrisome. Multiple bills are now pending before both the Senate and Assembly requiring a new regulatory review; forcing disclosure of hospital/doctor participation criteria; disclosing cost sharing agreements; establishing standards for networks; and freezing enrollment until new legislation and regulations governing tiered networks are in place. NJ’s legislators are concerned; so are we.
Featured News Article
Sweeney calls for another hearing on OMNIA
A surprise Friday morning announcement from Senate President Stephen Sweeney calls for what would be the second joint Senate committee hearing to scrutinize Horizon Blue Cross Blue Shield of New Jersey’s OMNIA plan since its rollout two years ago.
“More than two years have passed since the Senate Health and Commerce committees held a joint hearing to examine the potential impact of the Horizon OMNIA insurance product. Horizon executives made numerous representations to the joint committee during the hearing,” Sweeney (D-West Deptford) said in a statement.
Featured Multimedia Clip
NJ Lawmakers Will Hold Hearing On Horizon Products
The leader of the New Jersey Senate says lawmakers will hold a hearing to examine insurance products being offering by Horizon Blue Cross Blue Shield of New Jersey.
Senate President Steve Sweeney says he wants to make sure insurance companies aren’t making enormous profits at the expense of quality health care for consumers.
