horizon bcbsnj

What horizon bcbsnj does

Horizon Blue Cross Blue Shield of New Jersey is a private, tax-paying, not-for-profit health service corporation headquartered in Newark and an independent licensee of the Blue Cross Blue Shield Association. It is New Jersey's oldest and largest health insurer, serves more than 3.8 million members, and primarily offers medical, dental, vision, and prescription plans to individuals, families, and employers in the state.

Horizon reports a health information technology platform supporting value-based care arrangements, member services, telehealth, and related administrative workflows. The available data does not disclose a more detailed system architecture or named proprietary models, so the technology description is limited to these operating functions.

The core revenue mechanism is recurring health-insurance premiums from members and employers. Horizon reaches large employers and government entities through field sales and its exclusive administration of State and School Employees' Health Benefits Programs, while individuals and small groups use brokers, call centers, retail locations, kiosks, mobile enrollment, and digital tools.

Name

horizon bcbsnj

Legal name

Horizon Blue Cross Blue Shield of New Jersey

Website

https://horizonhealthnews.com

Company type

Private

Founded year

1932

Operating status

Operating

Short description

Horizon Blue Cross Blue Shield of New Jersey is a tax-paying, not-for-profit health insurer serving more than 3.8 million members with medical, dental, vision, and prescription plans across New Jersey.

Ownership category

akta.pro rank

Product category

Health Insurance

NAICS

Direct Health and Medical Insurance Carriers (524114), Direct Life, Health, and Medical Insurance Carriers (52411)

SIC

Accident & Health Insurance (6321), Hospital & Medical Service Plans (6324)

akta.pro primary industry

Large Group Health Insurance (Mid-Market & National Accounts) (FSAIAFAE)

akta.pro secondary industries

Employer-Sponsored Dental & Vision (Group) (FSAIAHAH), Commercial Vision Insurance Plans (Employer-Sponsored) (HLAEAJAA), MA-PD Plans (Medicare Advantage with Prescription Drug Coverage) (FSAIAGAG)

Keywords

• Health insurance plans
• Medicare Advantage coverage
• Medical insurance services
• Pharmacy benefit management
• Value-based care programs

Headquarters

HQ city

Newark

HQ country

United States

HQ region

North America

Offices2 records

Markets served

GTM type

B2B and B2C

Offering type

Services

Cost components

Personnel, Operations, Technology or R&amp, D, Marketing or Sales, Infrastructure

Revenue model

1. Health Insurance Premiums: Core revenue from collecting premiums from members and employers for medical, dental, vision, and prescription insurance coverage. Horizon BCBSNJ is a tax-paying, not-for-profit health service corporation.
2. Pharmacy Services: Revenue from pharmacy benefit management through partnerships with Prime Therapeutics and PillPack by Amazon Pharmacy for prescription home delivery services.
3. Value-Based Care Arrangements: Shared accountability arrangements with healthcare systems like Atlantic Health System where financial performance is tied to quality and cost outcomes.

Pricing tiers

Go-to-market motion3 records

Distribution channels6 records

Marketing channels12 records

Core offering

Horizon Blue Cross Blue Shield of New Jersey sells health insurance plans including medical, dental, vision and prescription drug coverage to individuals, families, employers, and government programs across New Jersey. The company also administers State and School Employees' Health Benefits Programs and operates Medicare Advantage plans through the Braven Health joint venture with Hackensack Meridian Health and RWJBarnabas Health.

Product overview

Horizon Blue Cross Blue Shield of New Jersey is a health insurance company offering a comprehensive portfolio of insurance products and services. The core offering consists of medical, dental, vision, and prescription insurance plans for individuals, employers, and government programs. This is supplemented by value-based care programs like Episodes of Care, community health initiatives such as the Newark Initiative addressing social determinants of health, and digital health tools including the Horizon Blue mobile app and CareOnline telehealth service. The company also offers Medicare Advantage plans through its Braven Health joint venture with Hackensack Meridian Health and RWJBarnabas Health, along with prescription delivery via PillPack.

Differentiator

Problem solved

Functional benefit

Brands

• Horizon Health News: Company's health news portal providing health and wellness articles
• Braven Health
• Horizon CareOnline
• Horizon EXPAND
• Horizon Connect
• Blue to You Van

Products and services

• Horizon BCBSNJ Health Insurance Plans Comprehensive medical, dental, vision and prescription insurance plans sold to individuals, families, small groups, mid-size employers, large employers and government accounts in New Jersey. Includes coverage options for individual marketplace, employer-sponsored and government-sponsored programs.
• Braven Health Medicare Advantage Plans Medicare Advantage plans for Medicare-eligible New Jersey residents offering $0 premium options, low out-of-pocket costs and flexible out-of-network coverage, with combined insurance and clinical provider network benefits.
• Horizon CareOnline Telehealth

Quantifiable outcome

• 5% reduction in total cost of care with Atlantic Health System shared accountability arrangement
• +5 more outcomes

Named customers4 records

Segments6 records

Ideal customer profiles4 records

Technology focussed No

API detail

Has API

No

API docs

API detail

Core technology

AI maturity

App detail

Feature6 records

Partnerships

Eleven partnerships are on record, tiered flagship, core and minor.

• Braven Health (Horizon, Hackensack Meridian Health, RWJBarnabas Health)flagshipStrategic or Co-development Partner · 1 January 2021Joint Medicare Advantage offering called Braven Health, launching January 1, 2021 in eight counties. Combines Horizon's insurance expertise with Hackensack Meridian Health and RWJBarnabas Health clinical capabilities.
• University of PennsylvaniacoreImplementation/ SI/ Consulting Partner · 1 January 2020Community health workers hired locally and trained by University of Pennsylvania as part of program reaching 24,000 at-risk residents.
• AbleTocoreTechnology or Integration · 1 January 2020Partnership to offer Horizon members free online therapy sessions, making mental health help much easier to access.
• XPRIZE FoundationminorGTM or Marketing Partner · 1 January 2020Joined coalition offering $5 million incentive for COVID-19 tests as part of XPRIZE-led competition seeking accurate, cheap, easy-to-use tests with quick reporting to accelerate safe return to work and school.
• Civica RxflagshipStrategic or Co-development Partner · 23 January 2019Horizon joined 17 other Blue Cross Blue Shield plans in partnership with Civica to create a new subsidiary drug company to bring new generics to market and lower prescription drug costs for consumers.
• Atlantic Health SystemflagshipStrategic or Co-development Partner · 1 January 2019Shared accountability arrangement covering 30,000 Horizon members in Atlantic Health's Clinically Integrated Network. Risk-sharing model with joint cost targets and quality goals. Resulted in 9%+ reduction in unnecessary hospitalizations and 5% reduction in total cost of care.
• RWJBarnabas Health and NJ Department of Human ServicesflagshipStrategic or Co-development Partner · 1 January 2019Public-private collaborative selected as 1 of 7 nationally to develop value-based model for Medicaid. First-of-its-kind partnership bringing together state Medicaid agency, largest NJ health insurer, and biggest healthcare system.
• Newark Beth Israel Medical Center (RWJBarnabas Health)coreStrategic or Co-development Partner · 1 January 2017Newark Initiative pilot program addressing social determinants of health in four Newark zip codes. Partnership between Horizon and Newark Beth Israel Community Health Workers. Results: 24% fewer ER visits, 25% lower cost of care, 35% increase in behavioral health visits.
• PillPack by Amazon PharmacycoreTechnology or IntegrationPrescription home delivery service making medication organization simple with upfront cost visibility. Members can choose PillPack home delivery from their member account.
• Prime TherapeuticscoreTechnology or IntegrationPharmacy benefit management partnership improving pharmacy convenience and ease with PillPack integration.
• Hispanic Family Center of Southern New JerseyminorStrategic or Co-development PartnerPartnership to bring more care to underserved communities, particularly Hispanic populations in southern New Jersey.

Scale indicators12 records

Recent moves8 records

Expansion highlights7 records

Direct peers

• CareFirst BlueCross BlueShield: CareFirst is a nonprofit BCBS licensee serving Maryland, the District of Columbia, and Northern Virginia, with comparable employer-sponsored group, individual, and Medicare products and similar scale (3.4M+ members), making it a strong operational peer.
• Independence Blue Cross: Independence Blue Cross is the largest BCBS licensee in southeastern Pennsylvania, directly comparable to Horizon as a regional Blue Cross Blue Shield nonprofit serving one state/region with employer, individual, and Medicare products through a similar provider-aligned value-based care model.
• Highmark Blue Cross Blue Shield: Highmark is a regional BCBS licensee serving Pennsylvania, Delaware, and West Virginia with commercial, Medicare Advantage, and value-based provider partnerships - closely mirroring Horizon's regional nonprofit BCBS model with integrated delivery partnerships.
• Excellus BlueCross BlueShield: Excellus is a nonprofit regional BCBS plan serving upstate New York, comparable to Horizon in its regional mutual/nonprofit structure, community-focused value-based care programs, and dominance of commercial and Medicare segments in its core geography.
• Empire BlueCross BlueShield: Empire BlueCross BlueShield is the BCBS licensee for the New York metro area, including northern New Jersey adjacent to Horizon's territory. It offers commercial, Medicare, and Medicaid products through similar provider-aligned models and competes for the same multi-state employer accounts.

Broad incumbents

• Cigna Group: Cigna is a national health insurer with strong commercial and Medicare Advantage offerings. It competes with Horizon for NJ large employer accounts and increasingly in value-based care arrangements, representing a national-scale competitor with broader geographic reach.
• UnitedHealthcare: UnitedHealthcare is the largest US health insurer by membership, offering commercial, Medicare Advantage, and Medicaid products nationally. It competes with Horizon for large NJ employer accounts and Medicare Advantage enrollment via AARP-branded MA plans.
• Humana: Humana is the second-largest US Medicare Advantage insurer and competes directly with Braven Health in the NJ Medicare market, with established MA provider partnership models (CenterWell) analogous to Horizon's Braven Health joint venture.
• Anthem Blue Cross Blue Shield: Anthem is the largest BCBS licensee operating across 14 states with substantially broader scale than Horizon. While it does not specialize in NJ, it competes for NJ large employer accounts and national accounts with similar BCBS-branded products and value-based care strategies.
• Aetna (CVS Health): Aetna, owned by CVS Health, is a major national diversified health insurer with significant NJ presence competing across commercial, Medicare, and individual lines - similar product breadth to Horizon but with national scale and integrated CVS pharmacy/care delivery assets.

Market position

Strengths5 records

Weaknesses5 records

Competitive moat6 records

Key risks6 records

Customer concentration

• Xtwitter.com/horizonbcbsnj
• YouTubeyoutube.com/bcbsnj
• Facebookfacebook.com/HorizonBCBSNJ
• LinkedInlinkedin.com/company/horizonbcbsnj
• Instagraminstagram.com/HorizonBCBSNJ

Revenue estimate

Valuation estimate

Number of profiles

Profiles7 records

Subsidiaries4 records

Funding overview

Funding rounds

Investors

Funding detail is available on the Subscription and Enterprise plan.Contact sales →

M&A

Investments

M&A and investment is available on the Subscription and Enterprise plan.Contact sales →

Frequently asked questions about horizon bcbsnj