Medical Loss Ratio · New Jersey · 2024 reporting year · BCBS OF NJ GRP · not-for-profit
Horizon Blue Cross Blue Shield of NJ
In New Jersey, over the three-year window through 2024, Horizon Blue Cross Blue Shield of NJ spent 82.8% of individual premiums on care, 89.6% of small group premiums on care, and 99.3% of large group premiums on care (its Medical Loss Ratio). It met the 80/20-rule floor in every market, so no rebate was owed.
Where each premium dollar went
The filled bar is the share of premiums spent on medical care + quality improvement — the three-year Medical Loss Ratio. The marker is the legal floor for that market (80% individual & small group, 85% large group). Below the floor, the insurer rebates the shortfall (floor − MLR), applied to that year's premium.
See what Horizon Blue Cross Blue Shield of NJsells on the marketplace — plan footprint and premium positioning — on its company profile, or browse all New Jersey marketplace plans. Complaint counts and loss ratios for Horizon Blue Cross Blue Shield of NJ (NAIC 55069) are on its carrier quality profile.
RECORDED — the Medical Loss Ratio, the 80/85% standard, premium earned, and the rebate owed are CMS-published figures (the 2024 MLR reporting year, a three-year window through 2024; rebates are paid the following year). DERIVED — rebate as a share of premium, and the rebate per enrollee (rebate ÷ member-years).
Machine-readable: JSON-LD · Markdown · Source: CMS — Medical Loss Ratio (MLR) Public Use File, 2024 reporting year
What this is — and is not
This is how Horizon Blue Cross Blue Shield of NJ spent premium dollars across its entire New Jersey book in each market — it is not a measure of a specific plan's quality, your denial odds, or whether the insurer is right for you, and it is not advice. A rebate, if owed, is a rule-based payment to policyholders (a check or premium credit) the following year. To compare plans, check eligibility, and enroll, go to HealthCare.gov.