A state appeals court has ruled that Horizon Blue Cross Blue Shield of New Jersey can proceed with the rollout of its two-tiered Omnia Health Alliance insurance plan, putting aside objections raised by 10 hospitals relegated to Tier 2 under the plan.
The appellants sought to overturn a ruling by the state Department of Banking and Insurance approving the Omnia plan, which gives lower deductibles and co-payments to members using a Tier 1 provider. The appeals court rejected their assertions that the Omnia plan does not comply with the state’s time and distance standards for network adequacy, and that the approval process was inadequate.
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