Horizon Blue Cross – Employment Verification for Husband/Wife Groups

Effective April 1, 2012, Employment Verification for Husband/Wife Small Groups forms will only be
accepted when a new group that has only two eligible employees who are husband and wife*
has not been in existence long enough to have payroll verification (Schedule C, K1s and/or
W-2 forms). At renewal, as part of the recertification process, these groups will be required
to provide the applicable payroll verification.

If the group is an established company, the Schedule C, K1s and/or W-2 forms must be
available to satisfy payroll requirements.

If you have any questions regarding these Horizon Blue Cross Blue Shield small group changes, contact a New Jersey insurance broker.

* References to Husband/Wife also include partners in a civil union or domestic partners (if applicable).