Blue Cross Blue Shield employer health plans in New Jersey
Who Blue Cross Blue Shield insures among New Jersey employers and what those plans pay in premium and broker compensation, and what the Blue Cross Blue Shield network pays physicians and hospitals.
Blue Cross Blue Shield employer health plans in New Jersey at a glance
What the data shows
Blue Cross Blue Shield insures 292 employer health plans in New Jersey (27% of 1,074 insured large plans), 2nd of 8 carrier groups; Cigna (389) hold more.
Blue Cross Blue Shield has shrunk 17% in New Jersey since 2020, from 353 plans, as insured plans moved carrier or to self-funding.
Most of these plans cover 100–499 people (166 plans); 6 cover 1,000 or more.
Median premium per person covered was $12,018, 51% above the New Jersey all-carrier median of $7,958. Benefit design and group mix differ, so this is not a price comparison.
78% of these plans reported broker or agent pay on their Blue Cross Blue Shield contracts; where paid, the median was 4.4% of premium (middle half 2.9%–5.8%).
In BCBS: Horizon Healthcare of New Jersey, 20 of the 50 Employer 50 services have a New Jersey benchmark, at a median of 120% of Medicare across those services.
At New Jersey hospitals, Blue Cross Blue Shield's commercial rates run higher than other carriers' at the same hospital for 7 of 17 services; a hip or knee replacement stay has a median rate of $37,387 across 37 hospitals.
Blue Cross Blue Shield plans in New Jersey, 2020–2024
| Form year | Plans | Persons covered | Share of state | Median premium / person |
|---|---|---|---|---|
| 2020 | 353 | 92,100 | 32% | $10,906 |
| 2021 | 337 | 86,692 | 31% | $10,820 |
| 2022 | 292 | 57,649 | 27% | $11,820 |
| 2023 | 291 | 52,158 | 27% | $11,711 |
| 2024 | 292 | 56,168 | 27% | $12,018 |
| 2025 (partial) | 207 | 35,292 | 27% | $12,064 |
Plan size
| Persons covered | Plans | Share |
|---|---|---|
| Under 100 | 105 | 36% |
| 100–499 | 166 | 57% |
| 500–999 | 13 | 4% |
| 1,000–4,999 | 6 | 2% |
| 5,000 or more | 0 | 0% |
Premiums and broker pay
| Measure | Blue Cross Blue Shield | All carriers, New Jersey |
|---|---|---|
| Median premium per person covered | $12,018 | $7,958 |
| Premium per person, middle half | $8,741–$16,113 | $3,994–$12,173 |
| Plans reporting broker or agent pay | 78% | 73% |
| Median broker pay, % of premium | 4.4% | 4.7% |
| Broker pay, middle half | 2.9%–5.8% | 3.0%–6.3% |
| Median broker pay per person covered | $502 | $365 |
Industries
Blue Cross Blue Shield's New Jersey employer clients are concentrated in manufacturing (60 plans) and professional and technical services (52), followed by health care and social assistance (43).
| Industry | Plans | Share |
|---|---|---|
| Manufacturing | 60 | 21% |
| Professional and technical services | 52 | 18% |
| Health care and social assistance | 43 | 15% |
| Finance and insurance | 20 | 7% |
| Retail trade | 19 | 7% |
| Wholesale trade | 18 | 6% |
Blue Cross Blue Shield employer clients in New Jersey
260 employers in New Jersey have a Blue Cross Blue Shield major-medical contract, 6 of them covering 1,000 or more people. For each one Medlyze has the plan year, the broker on each contract and what that broker was paid, and compiles the list for a state, an industry or a single employer on request.
| Employer | Persons covered | Plan year ends | Broker | Broker pay, % of premium |
|---|---|---|---|---|
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
| Employer name | Locked | Locked | Locked | Locked |
Brokers: request the Blue Cross Blue Shield Prospect List for New Jersey →
What the Blue Cross Blue Shield network pays physicians in New Jersey
| Service | Code | Median | Middle half | % of Medicare | Other networks, median | Provider groups |
|---|---|---|---|---|---|---|
| Echocardiogram, transthoracic complete with Doppler | 93306 | $81 | $68–$115 | 120% | $90 | 63 |
| Nuclear stress test (SPECT myocardial perfusion) | 78452 | $76 | $76–$115 | 102% | $93 | 63 |
| Skin biopsy, single lesion (tangential) | 11102 | $157 | $118–$200 | 165% | $140 | 66 |
| Abdominal ultrasound, complete | 76700 | $53 | $39–$72 | 142% | $54 | 72 |
| Bone density scan (DXA), axial | 77080 | $15 | $9–$22 | 155% | $14 | 71 |
| CT abdomen and pelvis with contrast | 74177 | $88 | $88–$171 | 105% | $123 | 71 |
| CT chest without contrast | 71250 | $56 | $56–$95 | 113% | $70 | 72 |
| Chest X-ray, 2 views | 71046 | $13 | $11–$20 | 131% | $15 | 74 |
| MRI brain without and with contrast | 70553 | $110 | $110–$197 | 105% | $153 | 72 |
| MRI cervical spine without contrast | 72141 | $72 | $72–$138 | 105% | $115 | 73 |
| MRI knee (lower-extremity joint) without contrast | 73721 | $69 | $65–$116 | 110% | $104 | 70 |
| MRI lumbar spine without contrast | 72148 | $72 | $72–$125 | 104% | $115 | 72 |
| MRI shoulder (upper-extremity joint) without contrast | 73221 | $66 | $66–$115 | 105% | $106 | 72 |
| Pelvic ultrasound, complete (non-obstetric) | 76856 | $40 | $33–$60 | 124% | $46 | 73 |
| Screening mammography, bilateral (incl. CAD) | 77067 | $42 | $32–$70 | 119% | $49 | 73 |
Professional fee only: facility, implant and anesthesia charges are not included. Limited: rates come from a sample of providers, and groups are counted only in specialties that perform the service.
What the Blue Cross Blue Shield network pays hospitals in New Jersey
Blue Cross Blue Shield commercial rates are on record at 48 New Jersey hospitals (the hospitals covered so far, not every hospital). Compared at the same hospitals, Blue Cross Blue Shield's rate is higher than the other carriers' median for 7 of 17 services and lower for 10. For Emergency visit, level 4, the rate runs from $1,082 to $2,812 across 24 hospitals.
This page shows 3 of the 17 services in full. The other rates, the size of each gap and every hospital's prices are in the Plan Cost Benchmark.
| Service | Hospitals | Median rate | Range (P10–P90) | vs other carriers, same hospitals | Cash price, median |
|---|---|---|---|---|---|
| Hip or knee replacement (hospital stay) | 37 | $37,387 | $27,685–$60,597 | Higher | $4,122 |
| C-section delivery (hospital stay) | 37 | Locked | Locked | Higher | Locked |
| Vaginal delivery (hospital stay) | 36 | Locked | Locked | Higher | Locked |
| MRI, lower back | 22 | $708 | $647–$1,044 | Higher | $594 |
| MRI, knee | 23 | Locked | Locked | Higher | Locked |
| CT, head | 24 | Locked | Locked | Higher | Locked |
| CT, abdomen and pelvis | 24 | Locked | Locked | Higher | Locked |
| Screening mammogram | 21 | Locked | Locked | Lower | Locked |
| Colonoscopy, diagnostic | 19 | Locked | Locked | Lower | Locked |
| Upper GI endoscopy with biopsy | 19 | Locked | Locked | Lower | Locked |
| Knee arthroscopy | 19 | Locked | Locked | Lower | Locked |
| Cataract surgery | 18 | Locked | Locked | Lower | Locked |
| Gallbladder removal, laparoscopic | 18 | Locked | Locked | Lower | Locked |
| Knee replacement, outpatient | 15 | Locked | Locked | Lower | Locked |
| Emergency visit, level 4 | 24 | $1,568 | $1,082–$2,812 | Lower | $664 |
| Comprehensive metabolic panel | 23 | Locked | Locked | Lower | Locked |
| Complete blood count | 23 | Locked | Locked | Lower | Locked |
Hospitals with the most published Blue Cross Blue Shield rates
| Hospital | Joint replacement | MRI lower back | CT abdomen | Colonoscopy | ER level 4 | Vaginal delivery |
|---|---|---|---|---|---|---|
| Clara Maass Medical Center | $40,203 | Locked | Locked | Locked | Locked | Locked |
| Community Medical Center | $37,274 | Locked | Locked | Locked | Locked | Locked |
| Cooperman Barnabas Medical Center | $37,671 | Locked | Locked | Locked | Locked | Locked |
| Jersey City Medical Center | $42,413 | Locked | Locked | Locked | Locked | Locked |
| Monmouth Medical Center | $35,930 | Locked | Locked | Locked | Locked | Locked |
| Monmouth Medical Center Southern Campus | $36,327 | Locked | Locked | Locked | Locked | Locked |
| Newark Beth Israel Medical Center | $35,837 | Locked | Locked | Locked | Locked | Locked |
| Robert Wood Johnson University Hospital | $35,869 | Locked | Locked | Locked | Locked | Locked |
| Robert Wood Johnson University Hospital At Rahway | $35,780 | Locked | Locked | Locked | Locked | Locked |
| Robert Wood Johnson University Hospital Hamilton | $37,982 | Locked | Locked | Locked | Locked | Locked |
How the contracts are written: case rates 14%, fee schedules 19%, per diem 0%, percent of billed charges 52%, other 15% of Blue Cross Blue Shield's published commercial rates for these services in New Jersey.
Employers: see all 17 services and every hospital near your people in a Plan Cost Benchmark →
Hospital facility rate only: physician, anesthesia and implant charges are separate. Rates are what hospitals publish, not claims paid, and are not weighted by use.
Carriers in New Jersey
| Carrier | Plans | Share | Median premium / person | Median broker % |
|---|---|---|---|---|
| Cigna | 389 | 36% | $5,225 | 6.1% |
| Blue Cross Blue Shield | 292 | 27% | $12,018 | 4.4% |
| UnitedHealthcare | 181 | 17% | $7,187 | 4.8% |
| Aetna | 158 | 15% | $6,883 | 3.3% |
| Other insurers (regional and local plans) | 135 | 13% | $6,086 | 5.9% |
| Kaiser Permanente | 129 | 12% | $8,788 | 3.7% |
| Anthem (Elevance Health) | 16 | 1% | $7,626 | 3.2% |
| Humana | 7 | 1% | $2,415 | 2.2% |
Blue Cross Blue Shield in other states
FAQ
How many New Jersey employers have Blue Cross Blue Shield health insurance?
292 employer health plans in New Jersey reported a Blue Cross Blue Shield major-medical contract in their 2024 filings, covering 56,168 persons. Self-funded plans that Blue Cross Blue Shield only administers are not counted.
What is Blue Cross Blue Shield's share of the New Jersey insured employer market?
27% of insured large employer health plans, 2nd of 8 carrier groups by plan count.
How much do brokers earn on Blue Cross Blue Shield plans in New Jersey?
Where broker or agent pay was reported, the median was 4.4% of premium (4.7% across all carriers in New Jersey).
Can I see the figures for a specific employer?
Yes. Brokers can request an Employer Account Brief on one employer, or a Prospect List for this market. Employers can request a Plan Cost Benchmark for their own plan. Use the request form on this page.
About these numbers
- Plans counted: the 292 New Jersey employer health plans with a Blue Cross Blue Shield major-medical contract in their 2024 filings. Self-funded plans that Blue Cross Blue Shield only administers are not counted here.
- Premium and broker figures: 258 contracts with 20+ persons covered and a reported premium; broker percentages use the 227 contracts that reported broker or agent pay.
- Network rates: BCBS: Horizon Healthcare of New Jersey, professional fees only, from a sample of providers.
- Hospital prices: Blue Cross Blue Shield commercial rates at New Jersey hospitals; stay and facility prices only.
- Full method and limits: how the employer health plan data is built.