Products and policies may be provided by Horizon Insurance Company and services and products may be provided by Horizon Blue Cross Blue Shield of New Jerseyor Horizon Healthcare of New Jersey, Inc., each an independent licensee of the Blue Cross and Blue Shield Association. Communications are issued by Horizon Blue Cross Blue Shield of New Jersey in its capacity as administrator of programs and provider relations for all its companies. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name and symbols are registered marks ofHorizon Blue Cross Blue Shield of New Jersey. OMNIASM is a service mark of Horizon Blue Cross Blue Shield of New Jersey. © 2016 Horizon Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey 07105-2200. 2426 (0116)

January 6, 2016

Applies to: All markets

Bayonne Medical Center and Hoboken University Medical Center terminate from the Horizon Hospital Network

CarePoint Health hospitals – Bayonne Medical Center and Hoboken University Medical Center – have terminated theirhospital contracts with Horizon Blue Cross Blue Shield of New Jersey. Please carefully read below to understand howthese network changes affect your Horizon BCBSNJ clients and their employees.

Bayonne Medical Center

Bayonne Medical Center has terminated its hospital contract effective 11:59 p.m., Eastern Time (ET), December 31, 2015. This means that Bayonne Medical Center will no longer be a participating hospital in the HorizonHospital Network effective January 1, 2016.

Under New Jersey state law and the terms of Horizon BCBSNJ’s contract with Bayonne Medical Center, all HorizonBCBSNJ members may continue to use Bayonne Medical Center through April 30, 2016 as a period for transition ofcare. Prior authorization must be obtained when required.

Beginning May 1, 2016, Bayonne Medical Center will be out of network for all Horizon BCBSNJ members.

Hoboken University Medical Center

Hoboken University Medical Center has terminated its hospital contract effective 11:59 p.m., ET, February 1, 2016. This means that Hoboken University Medical Center will no longer be a participating hospital in the Horizon HospitalNetwork effective February 2, 2016.

Under New Jersey state law and the terms of Horizon BCBSNJ’s contract with Hoboken University Medical Center, allHorizon BCBSNJ members may continue to use Hoboken University Medical Center through June 1, 2016 as a periodfor transition of care. Prior authorization must be obtained when required.

Beginning June 2, 2016, Hoboken University Medical Center will be out of network for all Horizon BCBSNJmembers.

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As required by state law, we are in the process of sending letters and a list of Horizon BCBSNJ network hospitals toaffected members. You can see the hospital list here.

As always, we are focused on ensuring that our members have access to needed care. Please see the answers below toquestions you may have about these changes to our hospital network.

Q1. How do these changes affect my clients’ benefits?A1. Your clients and their employees have the same basic health plan benefits. Horizon HMO, Horizon EPO,

OMNIASMHealth Plan, Horizon Medicare Blue Value (HMO), Horizon Medicare Blue Patient-Centered w/Rx (HMO) and Horizon Medicare Blue Choice (HMO) members and other members who do not have out-of-network benefits receive nonemergency hospital coverage only when they use hospitals in the Horizon Hospital Network.

Horizon POS, Horizon Direct Access, Horizon PPO, Horizon Medicare Blue (PPO), Horizon Medicare Blue Access Group and other Horizon BCBSNJ members with out-of-network benefits incur lower out-of-pocket costs and get the most from their benefits by using our Horizon Hospital Network.

Q2. What should my clients’ employees do in a medical emergency?A2. In case of a medical emergency, your clients’ employees should go to the nearest emergency facility

without worrying about network affiliations.

Q3. When do these changes take effect?A3. Bayonne Medical Center terminated its hospital contract with Horizon BCBSNJ effective 11:59 p.m., ET,

December 31, 2015. Under New Jersey state law and the terms of Horizon BCBSNJ’s contract with Bayonne Medical Center, all Horizon BCBSNJ members may continue to use Bayonne Medical Center at an in-network level of benefits through April 30, 2016 as a period for transition of care. Prior authorization must be obtained when required.

Beginning May 1, 2016, Bayonne Medical Center will be out of network for all Horizon BCBSNJ members.

Hoboken University Medical Center terminated its contract with Horizon BCBSNJ effective 11:59 p.m., ET, February 1, 2016. Under New Jersey state law and the terms of Horizon BCBSNJ’s contract with Hoboken University Medical Center, all Horizon BCBSNJ members may continue to use Hoboken University Medical Center at an in-network level of benefits through June 1, 2016, as a period for transition of care. Prior authorization must be obtained when required.

Beginning June 2, 2016, Hoboken University Medical Center will be out of network for all Horizon BCBSNJ members.

We encourage all members to use in-network hospitals to maximize their benefits and minimize their out-of-pocket costs.

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Q4. Why is Horizon BCBSNJ notifying its members about this termination?A4. Horizon BCBSNJ’s notification to its HMO, PPO and Medicare Advantage members is in accordance with the

law.

Q5. How can my clients’ employees find out about other hospitals in the network?A5. Your clients and their employees have a choice of network hospitals throughout New Jersey, and nearby in

Pennsylvania and Delaware. Your employees may search for hospitals participating in the Horizon Hospital Network by using our Online Doctor & Hospital Finder at HorizonBlue.com/doctorfinder.

We apologize for any inconvenience this may cause your clients and their employees. If you have questions, please contact your Horizon BCBSNJ sales executive or account manager.

HORIZON HOSPITAL NETWORK

(NJ – 61 Hospitals/76 Locations) (PA – 13 Hospitals/16 Locations) (NY – 2 Hospitals/2 Locations)1

(DE – 1 Hospital/1 Location)

ATLANTIC COUNTY AtlantiCare Regional Medical Center

(Atlantic City, Pomona, *Hammonton) Shore Medical Center BERGEN COUNTY Englewood Hospital and Medical Center Hackensack University Medical Center HackensackUMC at Pascack Valley Holy Name Medical Center The Valley Hospital BURLINGTON COUNTY Deborah Heart & Lung Center Lourdes Medical Center of Burlington Virtua - Memorial Hospital of Burlington County Virtua - West Jersey Health System (Marlton) CAMDEN COUNTY Cooper University Hospital Kennedy Memorial Hospitals - University Medical Center - Cherry Hill location - Stratford location Our Lady of Lourdes Medical Center Virtua - West Jersey Health System (Berlin, *Camden, Voorhees) CAPE MAY COUNTY Cape Regional Medical Center CUMBERLAND COUNTY Inspira Medical Center Vineland

*Inspira Medical Center Bridgeton ESSEX COUNTY St. Michael’s Medical Center Clara Maass Medical Center East Orange General Hospital HackensackUMC Mountainside Newark Beth Israel Medical Center Saint Barnabas Medical Center University Hospital GLOUCESTER COUNTY Kennedy Memorial Hospitals - University Medical Center - Washington Twp. location Inspira Medical Center Woodbury HUDSON COUNTY Bayonne Medical Center 2 Jersey City Medical Center Meadowlands Hospital Medical Center Hoboken University Medical Center 3

HUNTERDON COUNTY Hunterdon Medical Center

MERCER COUNTY Capital Health System - Fuld Capital Health Medical Center - Hopewell Robert Wood Johnson University Hospital Hamilton Saint Francis Medical Center MIDDLESEX COUNTY JFK Medical Center Raritan Bay Medical Center - Old Bridge location - Perth Amboy location Robert Wood Johnson University Hospital Saint Peter’s University Hospital University Medical Center of Princeton at Plainsboro MONMOUTH COUNTY Bayshore Community Hospital CentraState Medical Center Jersey Shore University Medical Center Monmouth Medical Center Riverview Medical Center MORRIS COUNTY Chilton Hospital Morristown Medical Center Saint Clare’s Hospital - Denville location - Dover location OCEAN COUNTY Community Medical Center Monmouth Medical Center, Southern Campus Ocean Medical Center (Brick , *Point Pleasant) Southern Ocean Medical Center PASSAIC COUNTY St. Joseph’s Hospital & Medical Center St. Joseph’s Wayne Hospital St. Mary’s Hospital SALEM COUNTY The Memorial Hospital of Salem County, Inc. Inspira Medical Center Elmer SOMERSET COUNTY Robert Wood Johnson University Hospital Somerset

SUSSEX COUNTY *Saint Clare’s Hospital/ Sussex Newton Medical Center UNION COUNTY *JFK Medical Center-Muhlenberg Campus Overlook Medical Center (Summit, *Union) Robert Wood Johnson University Hospital Rahway Trinitas Regional Medical Center WARREN COUNTY Hackettstown Regional Medical Center Saint Luke’s Warren Hospital PHILADELPHIA COUNTY, PA Children’s Hospital of Philadelphia Fox Chase Cancer Center Hahnemann University Hospital Hospital of the University of Penn. Jeanes Hospital Pennsylvania Hospital St. Christopher’s Hospital for Children Temple University Hospital Thomas Jefferson University Hospital (Main Campus and Methodist Campus) University of Pennsylvania Medical

Center - Presbyterian

BUCKS COUNTY, PA Rothman Orthopaedic Specialty Hosp.

DELAWARE COUNTY, PA Crozer Chester Medical Center

(Springfield Hospital, Taylor Hospital Campuses)

Delaware County Memorial Hospital NEW YORK (ORANGE COUNTY) Bon Secours Community Hospital 1

St. Anthony Community Hospital 1 DELAWARE A.I. DuPont Hospital for Children

Hospital-Based Physicians Not all hospital-based physicians are participating. Hospital-based physicians are identified as anesthesiologists, radiologists, pathologists and Emergency Room physicians providing services within the hospital. * No inpatient services/limited outpatient services available.

1 Bon Secours Community Hospital and St. Anthony Community Hospital will be out of network on 1/25/2016. 2 Bayonne Medical Center will be out of network on 5/1/2016. 3 Hoboken University Medical Center will be out of network on 6/2/2016. UUpdated: 12/20/2015.

Horizon Blue Cross Blue Shield of New Jersey is an independent licensee of the Blue Cross and Blue Shield Association. The Blue Cross® and Blue Shield® names and symbols are registered marks of the Blue Cross and Blue Shield Association. The Horizon® name and symbols are registered marks of Horizon Blue Cross Blue Shield of New Jersey. © 2016 Horizon Blue Cross Blue Shield of New Jersey. Three Penn Plaza East, Newark, New Jersey 07105.