Horizon BCBSNJ 2018 Medicare Advantage Offerings

Transcription

1 January 3, 2018 Applies to: Employer groups with five or more employees Horizon BCBSNJ 2018 Medicare Advantage Offerings Horizon Blue Cross Blue Shield of New Jersey is once again offering Medicare Advantage and Part D Prescription Drug plan options to small employer groups with five or more Medicare-eligible employees. Effective January 1, 2018, these plans include: For groups with members residing in New Jersey (view the brochure here): Horizon Medicare Blue Access Group (HMO-POS) Horizon Medicare Blue Access Group with Prescription Plan (HMO-POS) For groups with members residing anywhere in the United States, including New Jersey (view the brochure here): Horizon Medicare Blue Group (PPO) Horizon Medicare Blue Group with Prescription Plan (PPO) Stand-alone Part D Prescription Drug plan Under Medicare primary guidelines (TEFRA/DEFRA), the following groups are eligible to purchase the plans: Groups with fewer than 20 employees, with at least five Medicare-eligible beneficiaries and/or eligible dependents; members may be retired or actively working Groups with 20 or more employees, with at least five Medicare-eligible beneficiaries and/or eligible dependents; members must be fully retired (Continues) Products and policies may be provided by Horizon Insurance Company or Horizon Healthcare Dental, Inc. and services and products may be provided by Horizon Blue Cross Blue Shield of New Jersey or Horizon Healthcare of New Jersey, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey Horizon Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey (0117)

2 2018 Commission Schedule and Other Important Information View Horizon BCBSNJ s 2018 commission schedule here. Initial sales commissions are earned one month after the applicant s initial effective date of the policy. All renewals occur on January 1, regardless of the policy s original effective date. No formal testing or certification is required for brokers to sell Horizon BCBSNJ Medicare Advantage plans to groups. If you have questions, please contact Dana Gatto at Dana_Gatto@HorizonBlue.com or Heide Rivera at Heide_Rivera@HorizonBlue.com.

3 2018 Horizon Blue Cross Blue Shield of New Jersey Summary of Benefits and Rates * Horizon Medicare Blue Access Group (HMO/POS) Health Plans Horizon Medicare Blue Group Rx (PDP) Plans (may be offered with a group Medicare Advantage plan or as a stand-alone prescription-only option) HorizonBlue.com * Certain rules apply. This brochure is not intended for distribution to Medicare beneficiaries.

4 Horizon Medicare Advantage Group Health Plans: Summary of Benefits and Rates Summary: This is only a summary. Members will receive actual plan documents in full detail. MA (HMO-POS) options are available to actively working Medicare eligible employees for groups headquartered in New Jersey with less than 20 employees and/or retirees of all group sizes. Members must reside in New Jersey. Referrals to specialists are not required. This is a POS/Direct Access-type product using the Horizon Managed Care Network with an added out-of-network benefit. Prior authorization/precertification may be required for some services in and out of network. HORIZON MEDICARE BLUE ACCESS GROUP (HMO-POS) DESCRIPTION OF SERVICE IN-NETWORK OUT-OF-NETWORK DEDUCTIBLE $0 $900 MAXIMUM OUT-OF-POCKET $6,700 $6,200 INPATIENT HOSPITALIZATION $150 per day for days 1-10 $0 copay for days 11 and on Covered 65% after deductible is met Unlimited days as medically necessary Unlimited days as medically necessary Not to exceed $1,500 Not to exceed $1,500 OUTPATIENT HOSPITAL SERVICES Covered 80% Covered 65% after deductible is met AMBULATORY SURGICAL CENTER $100 copay Covered 65% after deductible is met PRIMARY CARE PHYSICIAN OFFICE VISITS $15 copay Covered 65% after deductible is met SPECIALIST OFFICE VISITS $35 copay Covered 65% after deductible is met EMERGENCY CARE $75 copay $75 copay URGENTLY NEEDED SERVICES Specialist copay Specialist copay RADIOLOGY SERVICES (OUTPATIENT HOSPITAL) Specialist copay Covered 65% after deductible is met THERAPEUTIC RADIOLOGICAL SERVICES (OUTPATIENT HOSPITAL) Covered 80% Covered 65% after deductible is met LAB SERVICES (OUTPATIENT HOSPITAL) Covered 80% Covered 65% after deductible is met HEARING SERVICES $0 copay for routine hearing exam Specialist copay for Diagnostic exam Covered 65% after deductible is met $750 towards purchase of single hearing aid for one ear and $500 towards second hearing aid for second ear within 1 year benefit period and 1 year supply of batteries VISION CARE $0 copay for routine eye exam, Glaucoma screening and Annual Diabetic Retinal exam Specialist copay for Diagnostic exam Covered 65% after deductible is met $100 reimbursement every 2 years for eyeglasses or contact lenses not associated with cataract surgery INPATIENT MENTAL HEALTH $150 per day for days 1-10 $0 copay for days 11 and on $750 towards purchase of single hearing aid for one ear and $500 towards second hearing aid for second ear within 1 year benefit period and 1 year supply of batteries $100 reimbursement every 2 years for eyeglasses or contact lenses not associated with cataract surgery Covered 65% after deductible is met Covers 60 lifetime reserve days when 90 days of your hospital stay are exhausted. Covers 60 lifetime reserve days when 90 days of your hospital stay are exhausted. There is a lifetime limit of 190 days for inpatient mental health services obtained in a psychiatric hospital. The 190-day lifetime limit does not apply to inpatient mental health OUTPATIENT MENTAL HEALTH Specialist copay Covered 65% after deductible is met SKILLED NURSING FACILITY Covered 100%. This benefit is limited to a maximum of 100 days per benefit period. There is a lifetime limit of 190 days for inpatient mental health services obtained in a psychiatric hospital. The 190-day lifetime limit does not apply to inpatient mental health Covered 65% after deductible is met. This benefit is limited to a maximum of 100 days per benefit period. PHYSICAL, OCCUPATIONAL & SPEECH THERAPY Specialist copay Covered 65% after deductible is met AMBULANCE Covered 100% Emergent: covered 100% Non-emergent: 65% after deductible is met MEDICARE PART B DRUGS Covered 80% Covered 65% after deductible is met HOME HEALTH CARE Covered 100% Covered 65% after deductible is met DURABLE MEDICAL EQUIPMENT Covered 100% Covered 65% after deductible is met 24/7 NURSELINE Covered 100% Members may call a registered nurse to ask questions about their health or medical treatment programs, 24 hours a day, 7 days a week. CHIROPRACTIC CARE Covered 100% for the manual manipulation of the spine to correct subluxation. Covered 65% after deductible is met for the manual manipulation of the spine to correct subluxation. PODIATRY Specialist copay Covered 65% after deductible is met PRESCRIPTION DRUG COVERAGE NOTE: Part D selection can be found on the back of this folder. Be sure to add Rx rate for total monthly premium. MEDICAL MONTHLY PREMIUM/ $205.51

5 Horizon Medicare Blue Group Rx (PDP) Plans: Summary of Benefits and Rates RETAIL MAIL ORDER Option Non- Specialty Non- Deductible Start of Coverage Gap Coverage In Gap 1Q Q Q Q $10 $10 $20 $35 $35 $20 $20 $40 $70 $0 No Gap N/A $ $ $ $ $10 $10 $20 $35 $35 $20 $20 $40 $70 $0 $4,500 Yes $ $ $ $ If you have questions about our group health plans for Medicare-eligible retirees, or for more information on our broker commission program, call your Horizon BCBSNJ Account Manager or your General Agent. Products indicated as no gap have additional drug coverage members pay the Rx rider cost share (ie:$10) throughout the coverage gap until $5,000 in out-of-pocket costs have been accumulated; amounts paid by brand Manufacturers during the Coverage Gap will apply towards the out-of-pocket accumulation. Products indicated with a starting gap amount do not have additional drug coverage members pay the Medicare Coverage Gap discount amount for brands (35% coinsurance) and the Rx rider Tier 1 and Tier 2 copays for generics. Catastrophic protection once a member has accumulated $5,000 in out-of-pocket costs (including the amount paid by brand Manufacturers during the Coverage Gap) is included. The protection is subject to the greater of 5% coinsurance payable by the insured and covers 95% of the allowed amounts, or $3.35 & $8.35, whichever is greater but not to exceed the Rx rider copays (ie: tier 3 preferred brand drug with $1,000 drug cost; 5% is $50 and Rx rider copay is $30, member will pay $30). Unlimited Drug coverage rider is included in each plan with a coverage gap limit members pay Tier 1 or Tier 2 generic copays. The EGWP formulary includes coverage of non-part D drugs referred to as supplemental drug coverage in the Horizon Formulary document (ie: cough & cold and erectile dysfunction drugs). Your standard Part D benefit has an Initial Coverage Limit (ICL) of $3,750. However, this group plan has extended your initial copayments into the coverage gap phase through Other Health Insurance (OHI) until a total drug cost of $4,500 has been reached. Quarterly Rx rates lock in at the time of sale for that benefit year, however, renew 1/1 of following year, regardless of time of sale. Please note that if the income of members enrolled in Medicare Part D is above a certain limit, your client may be required to pay an income-related monthly adjustment amount, in addition to their Horizon premium. This additional amount is called the Income-Related Monthly Adjustment Amount, also known as IRMAA. They must pay this extra amount directly to the government (not Horizon) for their Medicare Part D coverage. The booklet they receive called Medicare & You gives them information about the Medicare premiums in the section called Medicare Costs. This explains how the Medicare Part B and Part D premiums differ for people with different incomes. Horizon Insurance Company ( HIC ) contracts with CMS to offer group-medicare Advantage plans and group Part D Prescription Drug plans. Products are provided by HIC, however, communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. Both companies are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey Horizon, Three Penn Plaza East, Newark, New Jersey Horizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights laws and does not discriminate against nor does it exclude people or treat them differently on the basis of race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. Spanish (Español): Para ayuda en español, llame al (TTY/TDD 711). Chinese (TTY/TDD 711). Y0090_7057_COL_2017_Accepted

6 2018 Horizon Blue Cross Blue Shield of New Jersey Summary of Benefits and Rates * Horizon Medicare Blue Group (PPO) Health Plan Horizon Medicare Blue Group Rx (PDP) Plans (may be offered with a group Medicare Advantage plan or as a stand-alone prescription-only option) HorizonBlue.com * Certain rules apply. This brochure is not intended for distribution to Medicare beneficiaries.

7 There is a lifetime limit of 190 days for inpatient mental health services obtained in a psychiatric hospital. The 190-day lifetime limit does not apply to inpatient mental health Horizon Medicare Advantage Group Health Plans: Summary of Benefits and Rates GROUP MA PPO STANDARD OPTION 1 GROUP MA PPO STANDARD OPTION 2 GROUP MA PPO STANDARD OPTION 3 DESCRIPTION OF SERVICE IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK IN-NETWORK OUT-OF-NETWORK DEDUCTIBLE $0 $900 $0 $0 MAXIMUM OUT-OF-POCKET $5,000 $6,200 $10,000 combined In- and Out-of-Network $2,400 combined $1,000 combined INPATIENT HOSPITALIZATION $50 per day for days 1-10 OUTPATIENT HOSPITAL SERVICES/ AMBULATORY SURGICAL CENTER $0 copay for days 11 and on Covered 80% after deductible is met $500 per admission Covered 100% Unlimited days as medically necessary Unlimited days as medically necessary Unlimited days as medically necessary Unlimited days as medically necessary $100 copay Covered 80% after deductible is met $250 copay Covered 100% PRIMARY CARE PHYSICIAN OFFICE VISITS $10 copay Covered 80% after deductible is met $15 copay $10 copay SPECIALIST OFFICE VISITS $20 copay Covered 80% after deductible is met $25 copay $10 copay EMERGENCY CARE $75 copay $75 copay $75 copay $75 copay URGENTLY NEEDED SERVICES Specialist copay Specialist copay Specialist copay Specialist copay RADIOLOGY SERVICES (OUTPATIENT HOSPITAL) Specialist copay Covered 80% after deductible is met Specialist copay Covered 100% THERAPEUTIC RADIOLOGICAL SERVICES (OUTPATIENT HOSPITAL) $35 copay Covered 80% after deductible is met $60 copay Covered 100% LAB SERVICES (OUTPATIENT HOSPITAL) Covered 100% Covered 80% after deductible is met Specialist copay Covered 100% HEARING SERVICES $0 copay for routine hearing exam $0 Copay for routine hearing exam $0 Copay for routine hearing exam Specialist copay for Diagnostic exam Covered 80% after deductible is met Specialist copay for Diagnostic exam Specialist copay for Diagnostic exam $750 towards purchase of single hearing aid for one ear and $500 towards second hearing aid for second ear within 1 year benefit period and 1 year supply of batteries VISION CARE $0 copay for routine eye exam, Glaucoma screening and Annual Diabetic Retinal exam $750 towards purchase of single hearing aid for one ear and $500 towards second hearing aid for second ear within 1 year benefit period and 1 year supply of batteries $750 towards purchase of single hearing aid for one ear and $500 towards second hearing aid for second ear within 1 year benefit period and 1 year supply of batteries $750 towards purchase of single hearing aid for one ear and $500 towards second hearing aid for second ear within 1 year benefit period and 1 year supply of batteries $0 copay for routine eye exam, Glaucoma screening and Annual Diabetic Retinal exam $0 copay for routine eye exam, Glaucoma screening and Annual Diabetic Retinal exam Specialist copay for Diagnostic exam Covered 80% after deductible is met Specialist copay for Diagnostic exam Specialist copay for Diagnostic exam $100 reimbursement every 2 years for eyeglasses or contact lenses not associated with cataract surgery $100 reimbursement every 2 years for eyeglasses or contact lenses not associated with cataract surgery $100 reimbursement every 2 years for eyeglasses or contact lenses not associated with cataract surgery $100 reimbursement every 2 years for eyeglasses or contact lenses not associated with cataract surgery INPATIENT MENTAL HEALTH $50 per day for days 1-10 Covered 80% after deductible is met $500 per admission Covered 100% $0 copay for days Covers 60 lifetime reserve days when 90 days of your hospital stay are exhausted. Covers 60 lifetime reserve days when 90 days of your hospital stay are exhausted. Covers 60 lifetime reserve days when 90 days of your hospital stay are exhausted. Covers 60 lifetime reserve days when 90 days of your hospital stay are exhausted. There is a lifetime limit of 190 days for inpatient mental health services obtained in a psychiatric hospital. The 190- day lifetime limit does not apply to inpatient mental health There is a lifetime limit of 190 days for inpatient mental health services obtained in a psychiatric hospital. The 190- day lifetime limit does not apply to inpatient mental health There is a lifetime limit of 190 days for inpatient mental health services obtained in a psychiatric hospital. The 190-day lifetime limit does not apply to inpatient mental health OUTPATIENT MENTAL HEALTH Specialist copay Covered 80% after deductible is met $250 copay Covered 100% SKILLED NURSING FACILITY Covered 100%. This benefit is limited to a maximum of 100 days per benefit period. Covered 80% after deductible is met. This benefit is limited to a maximum of 100 days per benefit period. $0 for days 1-20 $75 for days This benefit is limited to a maximum of 100 days per benefit period. Covered 100%. This benefit is limited to a maximum of 100 days per benefit period. PHYSICAL, OCCUPATIONAL & SPEECH THERAPY Specialist copay Covered 80% after deductible is met Specialist copay Specialist copay AMBULANCE Covered 100% Emergent: Covered 100% Non-emergent: Covered 80% $100 copay Covered 100% MEDICARE PART B DRUGS Covered 100% Covered 80% after deductible is met 80% covered Covered 100% HOME HEALTH CARE Covered 100% Covered 80% after deductible is met Covered 100% Covered 100% DURABLE MEDICAL EQUIPMENT Covered 100% Covered 80% after deductible is met 80% covered Covered 100% 24/7 NURSELINE Covered 100% Covered 100% Covered 100% CHIROPRACTIC CARE $0 copay for the manual manipulation of the spine to correct subluxation. Members may call a registered nurse to ask questions about their health or medical treatment programs, 24 hours a day, 7 days a week. Covered 80% after deductible is met for the manual manipulation of the spine to correct subluxation. Members may call a registered nurse counselor to ask questions about their health or medical treatment programs, 24 hours a day, 7 days a week. Members may call a registered nurse counselor to ask questions about their health or medical treatment programs, 24 hours a day, 7 days a week. $20 copay for the manual manipulation of the spine to correct subluxation. Specialist copay for the manual manipulation of the spine to correct subluxation. PODIATRY NOTE: Part D selection can be found of this folder. Be sure to add Rx rate for total monthly premium. Specialist copay Covered 80% after deductible is met Specialist copay Specialist copay PRESCRIPTION DRUG COVERAGE NOTE: Part D selection can be found on the back of this folder. Be sure to add Rx rate for total monthly premium. NOTE: Part D selection can be found on the back of this folder. Be sure to add Rx rate for total monthly premium. on the back MEDICAL MONTHLY PREMIUM/** $ $ $ **A premium increase or decrease may apply to groups with 25+ Enrollees due to geographic location of retirees. Add Rx Monthly Premium/ rates, if applicable. See back cover for Rx rates.

8 Horizon Medicare Blue Group Rx (PDP) Plans: Summary of Benefits and Rates RETAIL MAIL ORDER Option Non- Specialty Non- Deductible Start of Coverage Gap Coverage In Gap 1Q Q Q Q $10 $10 $20 $35 $35 $20 $20 $40 $70 $0 No Gap N/A $ $ $ $ $10 $10 $20 $35 $35 $20 $20 $40 $70 $0 $4,500 Yes $ $ $ $ If you have questions about our group health plans for Medicare-eligible retirees, or for more information on our broker commission program, call your Horizon BCBSNJ Account Manager or your General Agent. Summary: This is only a summary. Members will receive actual plan documents in full detail. MA Group PPO options are available to actively working Medicare eligible employees for groups headquartered in New Jersey with less than 20 employees and/or retirees of all group sizes. Members may reside anywhere in the USA, including Puerto Rico. Referrals to specialists are not required. Prior authorization/precertification may be required for some services in and our of network. Products indicated as no gap have additional drug coverage members pay the Rx rider cost share (ie:$10) throughout the coverage gap until $5,000 in out-of-pocket costs have been accumulated; amounts paid by brand Manufacturers during the Coverage Gap will apply towards the out-of-pocket accumulation. Products indicated with a starting gap amount do not have additional drug coverage members pay the Medicare Coverage Gap discount amount for brands (35% coinsurance) and the Rx rider Tier 1 and Tier 2 copays for generics. Catastrophic protection once a member has accumulated $5,000 in out-of-pocket costs (including the amount paid by brand Manufacturers during the Coverage Gap) is included. The protection is subject to the greater of 5% coinsurance payable by the insured and covers 95% of the allowed amounts, or $3.35 & $8.35, whichever is greater but not to exceed the Rx rider copays (ie: tier 3 preferred brand drug with $1,000 drug cost; 5% is $50 and Rx rider copay is $30, member will pay $30). Unlimited Drug coverage rider is included in each plan with a coverage gap limit members pay Tier 1 or Tier 2 generic copays. The EGWP formulary includes coverage of non-part D drugs referred to as supplemental drug coverage in the Horizon Formulary document (ie: cough & cold and erectile dysfunction drugs). Quarterly Rx rates lock in at the time of sale for that benefit year, however, renew 1/1 of following year, regardless of time of sale. Please note that if the income of members enrolled in Medicare Part D is above a certain limit, your client may be required to pay an income-related monthly adjustment amount, in addition to their Horizon premium. This additional amount is called the Income-Related Monthly Adjustment Amount, also known as IRMAA. They must pay this extra amount directly to the government (not Horizon) for their Medicare Part D coverage. The booklet they receive called Medicare & You gives them information about the Medicare premiums in the section called Medicare Costs. This explains how the Medicare Part B and Part D premiums differ for people with different incomes. Horizon Insurance Company ( HIC ) contracts with CMS to offer group-medicare Advantage plans and group Part D Prescription Drug plans. Products are provided by HIC, however, communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. Both companies are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey Horizon, Three Penn Plaza East, Newark, New Jersey Horizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights laws and does not discriminate against nor does it exclude people or treat them differently on the basis of race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. Spanish (Español): Para ayuda en español, llame al (TTY/TDD 711). Chinese (TTY/TDD 711). Y0090_7058_COL_2017_Accepted

9 we re working together for the health of our members. Horizon BCBSNJ 2018 Medicare Advantage and PDP Employer Group Plans and 2018 Commission Rates Horizon BCBSNJ will continue to offer Medicare Advantage (MA) coverage to actively working Medicare-eligible employees in groups less than 20 and to Medicare-eligible retirees/dependents of 20+ group sizes with a minimum of five enrollees. We are pleased to provide groups with four plan options: One (HMO-POS) option and three MA (PPO) options as well as two stand-alone PDP offerings. The Part D employer group stand-alone plan options are available to retirees of all employer group sizes. With these group policies, referrals and Primary Care Physician selection are never required. Also, out-of-network benefits are included in all MA and MAPD Group Plan options. For large group business, brokers may contact the MA Account Managers listed on the back to discuss other plan options. Please MAPDGroups@HorizonBlue.com if you would like to receive our Broker Kits, which include these four benefit designs as well as the 2018 commission rates. Below is the 2018 MA and PDP Commission Schedule. Please note that all MA Group commissions for small groups with less than 50 employees will be paid solely through a Master Broker. Medicare Advantage Group Commissions Small Group <50 Employees Payment to Broker by Master Broker 5-49 Enrollees Large Group 50+ Employees Payment direct to BOR First 5-49 Enrollees Payment direct to BOR 50+ Enrollees Initial MA Sale* $567 $567 $200 Renewal MA** $284 $284 $75 Initial PDP Sale* $72 $72 $36 Renewal PDP** $36 $36 $18 HorizonBlue.com

10 As a broker, you are entitled to receive commissions in exchange for selling one of our Horizon Medicare Advantage (MA) or Prescription Drug Plan (PDP) group products. Initial sale commissions are earned one month after the applicant s initial effective date of the policy/ benefit contract. Commissions are paid solely through General Agents (GA) for small groups with less than 50 employees. Please note: First-year members must be enrolled for one full month for commissions. For all large groups greater than 50, GA override applies to the first 49 members. Broker Requirements A broker shall not publish nor distribute advertising collateral that has not been produced by Horizon BCBSNJ or Horizon Healthcare of New Jersey, Inc. All materials that originate from Horizon BCBSNJ have been submitted to the Centers for Medicare & Medicaid Services (CMS) and comply with all applicable state and federal laws. Brokers shall comply with state and federal laws regarding any sales transactions that take place and have association with the Horizon BCBSNJ brand name. As a broker, selling Horizon BCBSNJ MA, MAPD or PDP group retiree plans, all records must be kept and maintained for 10 years. These records must be available upon request to any Horizon BCBSNJ or CMS representative who may audit or review procedures for accuracy. License and Registration A broker is required to be licensed by the state of New Jersey in order to sell Horizon BCBSNJ Medicare products and must have a training session with the Horizon BCBSNJ MA Group Account Manager before selling said products. It is the broker s responsibility to renew his/her license and receive all applicable training to maintain active broker status with Horizon BCBSNJ. Member/Client Disclosure All brokers must disclose to the potential client/ enrollee that the broker receives commissions from Horizon BCBSNJ and is acting on behalf of Horizon BCBSNJ. Commission rates must meet the applicable regulatory requirements and may be subject to review and approval by Horizon BCBSNJ. For more information or questions please contact MA Account Managers Dana Gatto dana_gatto@horizonblue.com Heide Rivera heide_rivera@horizonblue.com The Power of Yes * Initial Sale commissions will not be payable for new enrollments received after the original effective date of an MA/MAPD/PDP contract. ** For business that renews during any subsequent period January 1st of each renewal year. Horizon Insurance Company ( HIC ) contracts with CMS to offer group-medicare Advantage plans and group Part D Prescription Drug plans. Products are provided by HIC, however, communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. Both companies are independent licensees of the Blue Cross and Blue Shield Association. The Blue Cross and Blue Shield names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey Horizon, Three Penn Plaza East, Newark, New Jersey Horizon Blue Cross Blue Shield of New Jersey complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, gender, national origin, age, disability, pregnancy, gender identity, sex, sexual orientation or health status in the administration of the plan, including enrollment and benefit determinations. Spanish (Español): Para ayuda en español, llame al (TTY/TDD 711). Chinese (TTY/TDD 711).