BROKER NEWSLETTER SEPTEMBER 2023

Our public website has a dedicated broker webpage to help you find the updated plan and product information you need during the busy open enrollment period and beyond, including access to your secure broker portal account.

Visit harvardpilgrim.org/broker and look for the following:

Can’t find what you’re looking for? Email the Broker & Employer Services Team at myserviceteam@point32health.org or call 800-637-4751.

Important information and updates to help you manage your clients’ needs.

We hope you are taking advantage of the new Online Quoting and Renewal functionality for pre-renewals that launched earlier this month for Maine and New Hampshire small groups. Later this fall, upon small group rate approval, online quoting and renewal access will be available in the new broker portal including the features and functions you have come to expect:

Simply login to the new broker portal to manage all your 2024 small group business in one location. This webinar will guide you through the new online quoting and renewal process.

Please note:  Any remaining 2023 small group activity for Maine and New Hampshire will continue to be managed in the HPOQ/R heritage portal, which can be accessed in the Quick Links section in the new broker portal.

We are excited to announce that Harvard Pilgrim has expanded its ElevateHealth network to include all contracted Ambulatory Surgical Centers in New Hampshire. This includes Huggins Hospital, who joined the ElevateHealth Network in January 2023. With this expansion, your clients will continue to gain access to high-quality care throughout the state of New Hampshire.

Learn More ›

We’re pleased to share that our commercial health plans continue to rank highly in 2023, according to the National Committee for Quality Assurance (NCQA).¹

These national ratings demonstrate a health plan’s ability to ensure high-quality care, provide members with top-notch service, and contribute to rigorous NCQA accreditation standards.

Learn More ›

¹The National Committee for Quality Assurance (NCQA) is a private, nonprofit organization dedicated to improving health care quality. NCQA Accredits and Certifies a wide range of health care organizations and recognizes clinicians in key clinical areas. NCQA’s HEDIS® is the most widely used performance measurement tool in health care. NCQA’s website contains information to help consumers, employers and others make informed health care choices.

As a reminder, the HMO enrollment area will change on January 1, 2024, to include fewer Connecticut zip codes applicable to our HMO plans. Employer groups may need to consider adding a PPO or POS plan design upon their 2023 renewal to accommodate employees residing in Connecticut. With this change, the HMO network will no longer include the majority of Connecticut providers starting January 1, 2024. Members impacted by these provider changes will receive a letter in November explaining their options. A copy of this letter will be available in the broker portal, for your reference.

As a reminder, you can use the Harvard Pilgrim Online Analytics (HPOA) tools to review claims and reporting activities in the broker portal. Data available should include claims incurred through June 30, 2023, and paid through August 31, 2023. Please note, due to the system outage, most claims received April through June 2023 were paid in July 2023. While it’s standard practice to use two months of runout for cost and utilization reporting, it’s especially important now given recent changes in claims payment patterns.

Enhancing value for members and clients

Harvard Pilgrim fully- and self-insured accounts now have access to the Noom weight loss program. Noom is an award-winning app-based weight loss program designed by psychologists and scientifically proven to create real, sustainable results through behavior change. Noom uses a personalized, mind-first approach that combines technology and human coaching to create healthier daily habits that lead to more sustainable weight loss. Employer groups must purchase a Noom license to access the program for their employees. Contact your account manager to learn more.

We are proud to announce our expanded Wellness Reimbursement program, which begins January 1, 2024. The Wellness Reimbursement expands upon the existing fitness reimbursement program to offer rebates on a broad range of wellness activities and expenses, including existing fitness subscriptions and fees. Harvard Pilgrim commercial plans sold to fully-insured large employer groups, and ASO plans that elect this option, will have access to the Wellness Reimbursement program. Small group plans will continue to only have access to the fitness reimbursement. 

As announced previously, starting November 1, 2023, we are fully integrating our behavioral health services to offer a whole-person care approach. As of October 31, United Behavioral Health will no longer manage behavioral health services; instead, our dedicated teams of clinicians and professionals will offer personalized, coordinated care.

This integrated approach to care strengthens our commitment to overseeing and managing our members' complete health care needs effectively. To support a seamless transition, this Behavioral Health overview provides additional details on these changes, including employer and member communications and timing. In addition, Harvard Pilgrim members actively engaged in behavioral health services today will receive a letter ahead of their new ID cards.

As a reminder, Harvard Pilgrim will no longer send out the annual mailing in the fall (October 2023) or any monthly notices (after December 2023) on your client’s behalf. All Harvard Pilgrim employer clients are now responsible for sending these notices to their applicable employees. For more information on Medicare Creditable Coverage, visit the CMS website which contains Updated Guidance, and Model Letters for Employer Use. 

Registration Reminders: Fall 2023 Broker Webinars

9:00 – 10:30 a.m.

These events will include behavioral health insourcing and network updates, pricing and trends, plus small group online quoting and renewal training. Visit our Broker Events page to register.

We offer new members access to specialized tools to simplify plan selection. Decision Doc, a personalized decision-support platform from HYKE (formerly MyHealthMath), helps take the guesswork out of your benefits plan selection and maximize savings for employees and their families.

Join our partner, HYKE, for a 30-minute webinar on September 28 at 9:00 a.m.

Easy access to the tools and resources you use most often.