Third Party Designation for Senior Citizen Insureds

Designating an additional person to receive your enrollment notifications

Members who are enrolled in a Horizon BCBSNJ commercial product (excludes Medicaid, Medicare Advantage and the Federal Employee Program®) and are age 62 years or older can designate an additional person to receive a copy of certain notices. These notices may include the following:

  • Premium payment past due
  • Enrollment termination
  • Cancellation of coverage
  • Nonrenewal or conditional renewal of policy

This information will be sent to you and the person you designate. To notify Horizon BCBSNJ of the person you have designated to receive these notices on your behalf, you need to:

  1. Complete the Third Party Designation form.
  2. Mail the form via certified mail to:

    Members without Medigap:

    Horizon BCBSNJ
    Attention: Consumer Enrollment Department
    PO Box 1330
    Newark, NJ 07101-1330

    Medigap members:

    Horizon BCBSNJ
    PO Box 10138
    Newark, NJ 07101-3147

Please allow up to 10 business days for Horizon BCBSNJ to process your request. This does not mean that the person you designate must pay your premium for you. It only means that they will get the same notice you get if you have missed a premium payment or there are changes to your health coverage due to a missed payment.

If you want to remove or change the person you have designated, you will need to notify Horizon BCBSNJ in writing to the correct address noted above.