NJCA, HPAE File Notice of Appeal on Superior Court’s Horizon Decision 

Trenton—June  20, 2023—New Jersey Citizen Action (NJCA) and Health Professionals and Allied Employees (HPAE) today filed a Notice of Appeal against a New Jersey Superior Court decision to allow Horizon Blue Cross Blue Shield to reorganize as a mutual holding company.  

The Court’s decision, if allowed to stand, is likely to result in significant healthcare premium hikes for millions of New Jersey policyholders to pay for the costly reorganization, despite Department of Banking and Insurance (DOBI) Commissioner Marlene Caride claiming otherwise. The proposed reorganization would cut out more than 2.5 million of Horizon’s current 3.8 million policyholders from membership and exclude them from the entity’s charitable mission to “provide affordable and accessible health insurance to its members.” 

“We will use every means at our disposal to continue our fight to protect Horizon’s policyholders and its billions of dollars in charitable assets,” said Maura Collinsgru, NJCA Director of Policy and Advocacy. “The Court’s error in upholding DOBI’s approval of the reorganization could have devastating consequences for millions of New Jerseyans already struggling to access affordable health care.” 

“We will continue to demand that the interests of all policy holders are protected,” said Debbie White, RN, HPAE President. “We believe that the State failed to place conditions on this deal that would have created safeguards for all of us. Healthcare costs are skyrocketing and without safeguards we are left vulnerable to the unjust business practices that place the interests of shareholders above those of policyholders.”  
 

NJCA and HPAE contend that the Court erred in making its decision by
 

• Failing to meet its obligation to conduct an independent, comprehensive review of the evidence. Instead, the Court deferred to DOBI’s decision, despite the fact it was not supported by the consultant’s reports, which have been kept confidential from the public. 
• Erroneously affirming DOBI Commissioner Marlene Caride’s decision that she must approve the reorganization unless it is “adverse” to the interests of the policyholders. The Commissioner’s decision failed to find policyholders would benefit from the reorganization, the standard required by law.  
• Ignoring the abundant evidence that the plan would actually harm Horizon’s policyholders. 
• Deciding that the lack of prior notice to policyholders and DOBI’s failure to make by-laws of the reorganized insurer public did not matter. The by-laws revealed that only about a third of Horizon’s current policyholders will be fully protected by the statutory requirement to provide affordable health insurance as part of the charitable mission historically required of Horizon. This decision prevented excluded policyholders and other members of the public from expressing their opposition to the proposed reorganization as currently structured. 

NJCA and HPAE will be filing a petition for certification with the Supreme Court by June 30^th. If the Court grants certification and agrees to hear the appeal, appellants would be granted oral argument with the intent of reversing the decision with a remand to the Commissioner to undertake review of the reorganization again. The new review would impose conditions ensuring the reorganization will benefit all policyholders, not just a portion, and that premiums would not increase for any policyholders. 

### 

New Jersey Citizen Action is a statewide advocacy and social service organization that advocates for social, racial and economic justice for all while also meeting the pressing needs of low and moderate income New Jerseyans through education and direct service. 

HPAE is the largest union of registered nurses and healthcare professionals in New Jersey representing 14,000 nurses, social workers, therapists, technicians, medical researchers, and other healthcare professionals in hospitals, nursing homes, home care agencies, blood banks, and university research facilities.  HPAE is affiliated with the American Federation of Teachers, AFL-CIO.