Horizon Blue Cross Blue Shield of New Jersey, one of the largest nonprofit health insurers in the state, is facing financial challenges of higher medical costs, officials said. Operation costs are down by $275 million over the past three years, but that’s not enough to offset the rising cost of health care, the company said. In November 2025, the insurer notified its employees that restructuring would take place in early 2026. On Monday, most of the impacted employees were informed that their positions were eliminated and offered separation packages. All the actions by Horizon since 2025 have reduced their workforce by 8%.