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Reporting Member’s Coverage Still Required by the ACA

November 16, 2018

Applies to: All Markets (Fully Insured)

Under the Affordable Care Act’s (ACA) Insurance Coverage Reporting requirement, Horizon Blue Cross Blue Shield of New Jersey must provide information to the Internal Revenue Service (IRS) about its fully insured members’ health insurance coverage using each subscriber’s Social Security Number (SSN) and the SSNs of any individuals covered under his or her policy.

Horizon BCBSNJ will once again collect and submit this information to the IRS on behalf of its fully insured members as proof that they had minimum essential health insurance coverage in 2018. Additionally, Horizon BCBSNJ is required to send the 1095-B Form to fully insured members by January 31, 2019, and electronically to the IRS by March 31, 2019, as proof of the coverage.

If Horizon BCBSNJ is unable to provide this information to the IRS because members have not submitted accurate information, the member may be subject to a financial penalty from the IRS.

Horizon BCBSNJ will report the required information to the IRS for our fully insured groups only.

Solicitation and collection of SSNs

Horizon BCBSNJ has identified the fully insured members who have missing or incomplete SSNs, and once again contracted with Thomson Reuters for the collection of that information.

Sometime next week, fully insured members who do not have a SSN on record with us will receive a letter from Horizon BCBSNJ with instructions on how to update their information. Only members who have missing information in our files will receive this letter.

Impacted members can provide the required information in one of the following ways:

  • Online – Sign in at HorizonBlue.com/1095 to update their information. Members will be redirected to a third-party website once signed in.
  • Email – Complete the paper form that is enclosed with the letter, and scan and email it to Midmajor_enrollment@HorizonBlue.com. Please include 01095SL in the subject line.
  • Mail – Complete and return the paper form that is enclosed with the letter.

Horizon BCBSNJ will not solicit for SSNs over the phone or through email.

Your clients’ employees’ information is secure and will be kept confidential. Third parties who conduct business on behalf of Horizon BCBSNJ are obligated to follow the same HIPAA security and privacy laws as Horizon BCBSNJ, and are obligated to safeguard our members’ information.¹

This information should not be construed as tax or legal advice. Questions your clients may have about their specific circumstances should be referred to their tax or legal professional.

Update for 2018: New Jersey Individual Mandate

Under a new state law, residents of New Jersey must have health insurance beginning January 1, 2019, or pay a penalty. New Jersey enacted this mandate because Congress repealed the penalties of the ACA’s individual mandate, effective December 31, 2018. This action ended the federal requirement that all individuals have health insurance.

New Jersey’s mandate, which mirrors the federal requirement, includes an annual penalty of 2.5 percent of a household’s income or a per-person charge — whichever is higher. The maximum penalty based on a per-person charge will be $2,085.

Individuals who purchase coverage directly from an insurance company or are covered under a group health plan comply with this mandate. A hardship exception for individuals who cannot afford coverage will be determined by the state treasurer.

If you have questions, please contact your Horizon BCBSNJ sales executive or account manager.

¹Privacy is important to us. We are committed to keeping our members’ personal information (PI) private. For detailed information on how we protect and safeguard, as well as use and disclose PI, please visit HorizonBlue.com/privacy-policy.

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Published on: November 19, 2018, 03:45 a.m. ET
Last updated on: November 20, 2018, 03:20 a.m. ET