As everyone should be aware by now, Horizon has made the decision that it will not extend the policies it cancelled, even though both the President and the Commissioner of Insurance in New Jersey have authorized them to do so.  It appears clear that the position of Horizon is that it has committed its resources, going forward, to only plans compatible with the Affordable Care Act.

As a provider, this could create problems for you in that the patients who you treat may select a different insurance provider on the exchange as the result of not being able to renew their Horizon policy, which will impact the patient-doctor relationship, depending on whether or not you are in network for the purposes of that policy.  As we pointed out in prior blogs, the other issue that you need to be concerned about, even though you may be in the network, are that physicians to whom you have referred this patient for additional care or institutions to which you have referred this patient, may no longer be in that network.

The additional change for your practice will be reorienting your staff towards the deductibles and the copays under the various levels of bronze, silver, gold or platinum policies.

In light of this business decision by Horizon, it would appear that as employer policies come up for renewal, Horizon will be looking at conforming them to the requirements of the Affordable Care Act probably, during 2014 and certainly, unless the waiver is extended, for 2015.  This, of course, will impact a much greater number of patients and beneficiaries, which will have an impact on a much greater number of providers.