Horizon Blue Cross Blue Shield of New Jersey has launched a new insurance plan for small- to medium-size businesses that it says can reduce costs by more than 20% for employers using self-funded plans.
Read more:
Horizon launches new self-funded health plan aimed at cutting costs for small, mid-size businesses
The new plan comes through HealthEZ, a company Horizon acquired last year that will serve as a third-party administrator.
Horizon’s new offering is built as a self-funded health benefits option. Employers keep more of the risk on their own books, instead of paying a fixed premium for fully insured coverage, but they also gain more control over how their plan is designed and managed.
HealthEZ CEO Jeff Bakke says employers that move to HealthEZ-administered plans have seen average savings of 20–23%, with some as high as 50%.
“We’re really obsessed with this,” he said. “We’re super aggressive in the way we manage the cost of care for the plan sponsor.”
Here are 10 things you need to know about the new plan:
10. HealthEZ is the engine behind it
HealthEZ, the Minnesota-based third-party administrator that Horizon acquired in 2025, brings a long history of running customized, self-funded plans for employers around the country. It will now serve as Horizon’s TPA platform in New Jersey.
9. Sales start this summer for 2027 coverage
The new product will be sold starting this summer for coverage that takes effect Jan. 1, 2027. That gives employers time to evaluate the approach as they plan for their next full plan year.
8. The plan targets employers with 50 to 2,000 employees
Horizon officials said they are aiming this offering at small and mid-sized employers, specifically those with 50 to 2,000 employees. That’s the slice of the market where they say many companies have struggled with rising costs and limited flexibility — but are big enough to consider self-funding.
7. It’s designed as “another arrow in the quiver” against rising costs
Horizon VP Jared Ferguson frames the new product as one more weapon for employers in a tough environment. “Our collaboration with HealthEZ is really about adding another arrow to a quiver of weapons that plan sponsors can use to fight these escalating costs,” he said.
6. It finally lets certain employers pair Horizon’s network with a TPA model
Until now, Horizon hasn’t offered a way for self-funded employers using TPAs to plug directly into its networks and solutions. “Candidly, the TPA model that we’re engaging through HealthEZ is one that our employer constituents in New Jersey have been asking about for some time,” Ferguson said.
5. Horizon sees a 400,000-life business opportunity
Horizon officials say there are about 400,000 members — employees and their dependent families — in New Jersey who are already in self-funded plans administered by TPAs that do not connect to Horizon’s network. They will be the initial priority for the rollout.
4. A custom plan design is a central selling point
One key difference from fully insured coverage: employers can custom-build their plan around their own employees’ needs and risks. Instead of a one-size-fits-most benefit package, Horizon and HealthEZ talk about “employee specification” and “customized individual attention” at the employer level as the source of a lot of the savings.
3. It leans on stop-loss protection to manage risk
Because this is self-funded, employers assume claim risk — but they’re expected to pair the arrangement with stop-loss coverage and HealthEZ’s cost-containment tactics. The idea is to blend self-funded flexibility with protection against catastrophic claims and more predictable long-term costs.
2. Claims and advocacy teams do the heavy lifting
Another big piece is active, hands-on management of claims and cases. HealthEZ staff work claim by claim to steer members to lower-cost sites of care, correct billing errors and pursue other insurance (like auto coverage after a car accident) before the employer’s health plan pays.
1. It’s a proof point for Horizon’s 2022 restructuring
The plan also illustrates how Horizon is using the flexibility it gained when New Jersey regulators approved its shift to a nonprofit mutual holding company structure in 2022. That change allowed Horizon to invest in subsidiaries like HealthEZ. Company officials now hold up this TPA-based product as one of the most significant examples of that strategy producing a concrete new option for New Jersey employers.
