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Horizon Stop Loss

Horizon BCBSNJ offers integrated Stop Loss Insurance solutions to help self-insured employers protect their financial stability by managing employee health care costs. Stop Loss helps businesses that want the advantages of self-funding reduce their risk of potentially catastrophic expenses from costly medical and prescription claims. With Horizon Stop Loss, Horizon BCBSNJ will pay for eligible claims that exceed the policy deductible.

We’re also committed to helping employers keep employee health care costs in check. Every Horizon Stop Loss contract now includes our Primary Nurse program. Depending on the number of employees, one or more Primary Nurses are assigned to the employer to help employees with acute and chronic conditions get appropriate care in the most cost-efficient environment—and the nurses’ efforts pay off. In fact, our analysis shows an estimated 7% reduction in total medical costs with this integrated solution.

Why Horizon BCBSNJ for Stop Loss?

With Horizon BCBSNJ as your single stop for end-to-end employee insurance, you get expertise that is guided by principles, not profits, and backed by the strength of an organization that has brought peace of mind to millions serving New Jersey for nearly a century.

Choose Horizon BCBSNJ for:

  • A Trusted Partnership

    We are committed to improving care quality and patient satisfaction, while reducing the cost of coverage for employers.
  • Dependability

    Backed by our overall strength and experience, we have an “A” rating and a “Stable” outlook from Standard & Poor’s. We have the confidence, strength and capability to protect our client’s financial well-being.
  • Streamlined Processes and Faster Reimbursement

    We offer immediate reconciliation and issue timely claim reimbursements. We combine billing and monthly claims summaries, and on each statement show you which claims were eligible for coverage.

    We’ve eliminated lengthy claims filings to reduce paperwork.

    With Horizon BCBSNJ as the stop loss carrier and claims administrator, and Prime Therapeutics as the pharmacy benefit manager (PBM), you benefit from a strategic alliance that enables our service team to adequately assess claims data, analyze possible claims trends and effectively engage appropriate cost-management resources.

Stop Loss Brochure

Primary Nurse Brochure