Which plan is right for you?
Choosing your plan is an important decision. Download this guide to compare plans side-by-side
What is my contribution?
This chart shows your bi-weekly contribution amount for medical, dental and vision plans.
Member Guide
In our new 2024 Member Guides, you will find a benefit summary, provider network information, member perks, and more.
Open Enrollment Presentation
An overview of Point32Health 2024 medical plans
This plan provides in-network coverage only. This plan does not have a deductible. Members are not required to select a PCP or obtain referrals for specialist care. In-network providers and facilities include Harvard Pilgrim’s network in Massachusetts, New Hampshire and Maine, and our national partner’s network, UnitedHealthcare Choice Plus, for the remaining states. Members are required to stay in-network with Harvard Pilgrim or UnitedHealthcare for benefit coverage.
Plan documents
- Schedule of Benefits
- Pharmacy Rider
- Summary of Benefits + Coverage (SBC)
- 2024 Benefit Handbook
- Letter to share with your provider
- Sample Member ID Card
Additional resources
This plan offers in-network coverage only. This plan has a deductible. Members are not required to select a PCP or obtain referrals for specialty care. In-network providers and facilities include Harvard Pilgrim’s network in Massachusetts, New Hampshire and Maine, and our national partner’s network, UnitedHealthcare Choice Plus, for the remaining states. Members are required to stay in-network with Harvard Pilgrim or UnitedHealthcare for benefit coverage.
Plan documents
- Schedule of Benefits
- Pharmacy Rider
- Summary of Benefits + Coverage (SBC)
- 2024 Benefit Handbook
- Letter to share with your provider
- Sample Member ID Card
Additional resources
This plan offers both in-network and out-of-network coverage. This plan has a deductible. The in-network member cost share mirrors the Access America Value with Deductible plan cost share. Members are not required to select a PCP or obtain referrals for specialty care. In-network providers and facilities include Harvard Pilgrim’s network in Massachusetts, New Hampshire and Maine, and our national partner’s network, UnitedHealthcare Choice Plus, for the remaining states. In addition to the Harvard Pilgrim and UnitedHealthcare networks, members may see out-of-network providers, at a higher cost.
Plan documents
- Schedule of Benefits
- Pharmacy Rider
- Summary of Benefits + Coverage (SBC)
- 2024 Benefit Handbook
- Letter to share with your provider
- Sample Member ID Card
Additional resources
This plan offers both in-network and out-of-network coverage. This plan has a deductible and allows you to open an associated Health Savings Account (HSA). Members are not required to select a PCP or obtain referrals for specialty care. In-network providers and facilities include Harvard Pilgrim’s network in Massachusetts, New Hampshire and Maine, and our national partner’s network, UnitedHealthcare Choice Plus, for the remaining states. In addition to the Harvard Pilgrim and UnitedHealthcare networks, members may see out-of-network providers, at a higher cost.
Plan documents
- Schedule of Benefits
- Pharmacy Rider
- Summary of Benefits + Coverage (SBC)
- HSA Employer Contribution
- 2024 Benefit Handbook
- 2024 Preventive Drug List
- Letter to share with your provider
- Sample Member ID Card
Fidelity HSA information
- Guide to understanding a Health Savings Account
- Checklist for using your HSA to its full potential
- HSA Tax Savings Trifecta
- Fidelity HSA Terms and Conditions
- HSA Qualifying Expenses
HSA Asset Transfer Information
- HealthEquity Transfer Key Dates
- HealthEquity Transfer Communication
- HealthEquity Transfer Authorization
- Bend Transfer Key Dates
- Bend Transfer Communication
- Bend Transfer Authorization
Additional resources
The Delta Preferred Option USA Plus plan combines two of Delta’s national networks, the Delta Premier Network and the Delta Preferred Network. Employees who use providers in the Preferred network (who generally accept lower payments from Delta) will make better use of the annual maximum benefit.
View presentation
Subscriber Certificate
Standard option
Eligible dental claims are paid at 100%, 80% or 50%, based on the dental procedure. The annual maximum is $1,500 per member. The plan also includes 50% orthodontic coverage up to a $1,500 lifetime maximum for all plan members. Varying deductibles apply. Coverage options are Individual, Two Person and Family.
For more information about the dental plan please visit the Delta Dental website.
High option
Eligible dental claims are paid at 100%, 90% or 60%, based on the dental procedure. The annual maximum is $2,000 per member. The plan also includes 50% orthodontic coverage up to a $2,000 lifetime maximum for all plan members. Varying deductibles apply. Coverage options are Individual, Two Person and Family.
For more information about the dental plan please visit the Delta Dental website.
Rollover Max from Delta Dental
A Delta Dental benefit feature that lets you roll over part of your unused spending in one year to increase your benefits for the following year, and beyond.
Additional Delta Dental resources
The EyeMed Vision Care Materials Only plan is a voluntary benefit that offers employees coverage and discounts for lenses, frames, contacts, and Lasik surgery. This benefit is available to eligible employees and is separate from what is offered through the medical plans.
The biweekly cost of participating in this plan:
- Employee: $1.33
- Employee + Child(ren): $2.53
- Employee + Spouse: $2.67
- Family: $3.92
Review coverage and discounts in the EyeMed Vision Care Materials Only Plan (Group #1034377)
Vision exams and discounts
Employees who are Harvard Pilgrim Health Care members are covered for an annual routine eye exam through their medical plan. Please remember to present your member ID at the time of an annual eye exam.
In addition members can use the EyeMed Vision Care Network and eyewear discounts available through the medical plan. View details of the discounts offered through the medical plans.
More from EyeMed
Maven is the world’s largest virtual clinic for women and families that provides around-the-clock care and support for you and your partner. Get access to unlimited 24/7 video appointments and messaging with providers from 35+ specialties, a dedicated Care Advocate to help find the right Maven providers, and hundreds of expert-vetted articles, on-demand classes, and drop-in groups. Maven is included at no cost as part of your Harvard Pilgrim health plan.
Ovia Health is an individual and family health and wellness program designed to guide a member through some of life’s biggest transitions: planning and starting a family, navigating pregnancy, balancing life as a working parent, and managing menopause.
Retiring soon? Learn more about Social Security Benefits and Medicare options.
Presentation Highlights
Social Security
- What is Social Security?
- Social Security benefits
- How work affects filing
Medicare
- What is Medicare? (Eligibility, Enrollment)
- What is covered and not covered
- Deductibles and coinsurance
- Medicare Beneficiary Resource Guide
Products
- Medicare Supplements
- Medicare Advantage Plans
- Medicare Prescription Drug Plans (Part D)
Selecting benefits can be overwhelming. Use Decision Doc by HYKE to help you determine which benefits are the best fit for you and your family.
Email SmartStart at [email protected] to ask questions regarding your medical or pharmacy benefits.
Call SmartStart at 866-874-0817 to discuss your unique complex medical or pharmacy concerns with clinical experts.
Flexible Spending Accounts allow you to make contributions to a special account and not pay federal income tax, Social Security tax and state tax on those contributions. Contributions are conveniently deducted from your paycheck. The health care FSA overs eligible expenses for you and your dependents that are not reimbursed by any medical, dental, vision, or other benefit plan. It is administered by Wex.
How does it work?
- Employees can contribute a minimum of $100 and a maximum of $3,050 per year.
- The amount you choose is evenly deducted from your paychecks throughout the year.
- The entire amount is available for employees to use as of January 1, 2024.
- Health Care contributions made in 2024 may be used until March 15, 2025.
- All claims must be submitted by April 30, 2025.
- An FSA Debit Card is provided for easy access to account funds.\
- Any funds left in the FSA account after April 30, 2025, will be forfeited and used to cover the administrative expenses.
Examples of eligible expenses:
Office visits, hospital and pharmacy co-payments
Vision expenses (eyeglasses, contacts)
Dental expenses
Durable Medical Equipment co-insurance
Certain over-the-counter (OTC) drugs and medicines with a prescription
Flexible Spending Accounts allow you to make contributions to a special account and not pay federal income tax, Social Security tax and state tax on those contributions. Contributions are conveniently deducted from your paycheck. For employees enrolled in the HSA medical plan offered by Point32Health, a Limited Purpose FSA covers eligible expenses for you and your dependents that are not reimbursed for dental or vision expenses only. A Limited Purpose FSA can be used in conjunction with a Health Savings Account. It is administered by Wex.
How does it work?
- Employees can contribute a minimum of $100 and a maximum of $3,050 per year.
- The amount you choose is evenly deducted from your paychecks throughout the year.
- The entire amount is available for employees to use as of January 1, 2024.
- Limited Purpose FSA contributions made in 2024 may be used until March 15, 2025.
- All claims must be submitted by April 30, 2025.
- An FSA Debit Card is provided for easy access to account funds.
- Any funds left in the FSA account after April 30, 2025, will be forfeited and used to cover the administrative expenses.