Horizon application 2026

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4.4 out of 5

134 votes

The document provides detailed instructions for small employers in New Jersey applying for health insurance coverage through Horizon Blue Cross Blue Shield. It outlines the necessary forms to be completed, including the Small Employer Health Benefits Policy Application and Certification, as well as additional required documents based on group size and payment methods. The document emphasizes the importance of accurate information submission and includes guidelines for enrollment, premium payments, and compliance with federal regulations.

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Click 'Get Form' to open the horizon application in the editor.
Begin by filling out Section I: Policyholder Information. Enter the full legal name of your company, Tax Identification Number, and main address. Ensure all fields are completed accurately.
Proceed to specify the type of organization and nature of business. Indicate the number of full-time employees and those to be insured.
In Section II, select your desired health benefits options from the provided list. Make sure to check any additional coverage options that apply.
Complete Section III by answering all questions regarding current or prior group health plans and any applicable COBRA requirements.
Finally, review all sections for accuracy, sign where required, and submit your completed application through our platform for processing.

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Versions	Form popularity	Fillable & printable
2023	4.2 Satisfied (49 Votes)
2022	4.8 Satisfied (55 Votes)
2020	4.8 Satisfied (247 Votes)
2020	4.2 Satisfied (36 Votes)
2020	4.8 Satisfied (101 Votes)
2020	4.4 Satisfied (134 Votes)
2020	4.3 Satisfied (26 Votes)
2020	4.7 Satisfied (51 Votes)
2020	4.8 Satisfied (261 Votes)
2020	4.1 Satisfied (59 Votes)
2020	4.8 Satisfied (117 Votes)
2019	4.8 Satisfied (35 Votes)
2019	4.8 Satisfied (142 Votes)
2019	4.8 Satisfied (54 Votes)
2019	4.8 Satisfied (51 Votes)