Insurance coverage for you and any eligible family members, including domestic partners, is available when you first become eligible to enroll, during our annual open enrollment period, or if you experience certain qualified events, e.g. marriage, divorce, birth of child, loss of other coverage, change in dependent eligibility, etc. Please refer to the applicable Health and Welfare Summary Plan Description and Certificate of Insurance for more details or contact Human Resources.
Access our updated Benefits Guide.
When you enroll in a plan, your share of any required premiums will be deducted each pay period on a pre-tax basis under the Flexible Benefit Plan.
What is Covered?
The documents listed below describe what types of expenses and services are covered by each plan. Select the appropriate benefit and document to get more information.
Harvard Pilgrim HMO Benefit Handbook 2024 (coming soon)
Harvard Pilgrim HDHP PPO Benefit Handbook 2024 (coming soon)
Harvard Pilgrim Best Buy HMO Schedule of Benefits 2024
Harvard Pilgrim HDHP PPO Schedule of Benefits 2024
Harvard Pilgrim HMO Schedule of Benefits 2024
HealthAdvocate Healthcare Help
Bentley provides a free and confidential service to all employees and their spouses, dependent children, parents and parents-in-law to assist with health and eldercare related matters. HealthAdvocate is staffed with registered nurses, who can assist with insurance cost estimates, claims and appeals, finding the right doctors, scheduling appointments, understanding test, treatments and medications and more.
Call 866.695.8622 for assistance. An Authorization Form is required for HealthAdvocate to work on your behalf or on behalf of a dependent minor.
Harvard Pilgrim Health Care - Machine-Readable Files
As part of the Transparency in Coverage Final Rule set forth by the U.S. Department of the Treasury, the U.S. Department of Labor, and the U.S. Department of Health and Human Services (referred to collectively as the “Tri-Agencies”), group health plans and health insurance issuers are required to make available to the public negotiated rates for all covered items with in-network providers, and historical payments to and billed charges from, out-of-network providers through machine-readable files (MRFs) posted on an internet website, updated monthly. These files will permit the public to have access to health plan payment information that can be used to understand health plan pricing and the cost for health care services.
The files that are posted will include:
- In-network provider negotiated rate files
- Out-of-network provider historic allowed amount files
- Table of Contents files
To ensure data integrity, all files must conform to a non-proprietary, open standard format, like JSON, XML or YAML, and be made available via HTTPS. The content of the files is formatted to technical standards in guidance published by the Centers for Medicare & Medicaid Services (CMS). See CMS Technical Guidance for reference.
Harvard Pilgrim Health Care will publish machine-readable files in the JSON format to its website on or around the first day of every month.
Harvard Pilgrim Health Care will generate machine-readable files for its various plans and group health plan clients. From the “View Plan List” link below you can choose the plan for which you wish to access machine readable files.