PLAN
&
TELEPHONE #
#002 - TRADITIONAL1
1-800-414-7427
www.horizonblue.com
#001 - NJ PLUS
www.horizonblue.com

#019
AETNA HMO
Active
1-800-309-2386
www.aetna.com

#020
CIGNA HEALTHCARE
1-800-244-6224
www.cigna.com/health
#028
OXFORD HMO
1-800-760-4566
www.oxfordhealth.com
#033
AMERIHEALTH HMO
1-800-877-9829
www.amerihealth.com
#034
HEALTH NET6 HMO
1-800-441-5741
www.healthnet.com
PLAN
&
TELEPHONE #
In-network
1-800- 414-7427
Out-of-network1
1-800-414-7427
SERVICE AREA Unrestricted All of NJ and FL;
Parts of NY and PA		 Unrestricted All of NJ, CT, DE, ME, and Wash.DC; Parts of AZ, FL, IL, IN, MA, MD, NC, NH, NV, NY, OH, PA, TX, and VA All of NJ, AZ, CT, DE, SC and Washington DC; Parts of CA, FL, GA, MD, NC, NY, PA, VA, and WV, All of NJ; parts of NY All of NJ and DE; parts of PA All of NJ and CT; Parts of NY SERVICE AREA
HOSPITAL
INPATIENT		 100% for up to 365 days; day 366+ at 80% after deductible 100% 70% after $200 per hospital stay deductible 100% 100% 100% 100% 100% HOSPITAL
INPATIENT
SKILLED
NURSING
FACILITY		 100% for up to 30 days per confinement 100% up to 120 days per calendar year 70% for up to 60 days per calendar year 100%; unlimited days 100%; unlimited days 100% up to 120 days per calendar year 100% up to 180 days per calendaryear 100% up to 120 days per confinement SKILLED
NURSING
FACILITY
HOSPITAL
PRE-ADMISSION
TESTING		 100% 100% 70% after deductible 100% 100% 100% 100% 100% HOSPITAL
PRE-ADMISSION
TESTING

1Benefits, excluding hospital expenses, are based on the Horizon's discounted provider network allowance or the "reasonable and customary" fee schedule at the 90% percentile. Some State employees may not be eligible for
enrollment in the Traditional Plan; see other side of chart for details.

6Referral is not required from a PCP to a participating specialist.