Audit of the Pension Plan at a Terminated Medicare Contractor, Horizon Blue Cross Blue Shield of New Jersey

EXECUTIVE SUMMARY:

Horizon was a Medicare contractor until its contract was terminated in 2000.  Because Medicare contracts specifically prohibit contractors from profiting from Medicare activities, pension gains which exist when a Medicare segment closes must be credited back to the program.  Accordingly, we recommended that Horizon remit $3,812,504 in excess pension assets to the Medicare program.