BROKER NEWSLETTER NOVEMBER 2023

We offer a variety of programs, tools, resources and welcome communications to help guide new members through plan details, provider searches and more.

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

We are thrilled to announce the appointment of expanded roles for Kate Skouteris and Bill Bourassa in support of our new Regional Markets structure which unifies Maine, New Hampshire and Rhode Island.* 

With these changes, we look forward to Kate and Bill’s continued success with our organization in support of your needs, as well as our mutual clients. 

*The Massachusetts market remains as is with no changes in leadership or current teams.

Our 2024 Broker Compensation Program details will be available later this month. Each state’s market will continue to offer defined programs to support new group sales, as well as rewards for retained groups. Log in to our Broker Portal under the general materials tab to view specific details. 

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.

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.

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2024 Harvard Pilgrim Plan Updates: Medicare Non-Compliance

There are several Maine and New Hampshire plans whose pharmacy coverage (Rx) component does not meet Medicare Creditable Coverage standards. Click here for a list of plans by state.

Employers can use the Model Individual Non-Creditable Coverage Disclosure Notice Language letter to inform employees of the Medicare Non-Creditable Coverage plans.

Small group brokers are now able to manage their 2024 small group quoting and renewals through the broker portal. Pre-renewals for 2024 began in September followed by online quoting and renewal activities in November. Brokers can simply log in to the broker portal to manage their 2024 small group business for all states in one location.

If you have not used our portals previously, we encourage you contact your Broker Administrator and log in for this best-in-class tool.

Enhancing value for members and clients.

Harvard Pilgrim Behavioral Health Insourced Program

One of our top priorities this year was to improve health outcomes in the communities we serve. As of November 1, 2023, we have completed a significant milestone in our behavioral health integration journey — members of nearly all our products will now receive insourced behavioral health services. This approach will now allow members to contact Harvard Pilgrim member services with all questions about claims, benefits and coverage related to both their physical and behavioral health.

In addition, our members can now access a comprehensive network of providers who can provide the inpatient and outpatient care they need. An internal care management team of seasoned clinicians, peer specialists and service navigators are also available to support them in managing and navigating their care.

NEW: Wellness Reimbursement Program 

Our expanded Wellness Reimbursement program begins January 1, 2024. This is an update to the existing fitness reimbursement program and offers 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 of November 1, 2023, all Harvard Pilgrim members now have access to AbleTo mental health support. This program aims to seamlessly combine on-demand, self-care tools and personalized virtual therapy sessions. Access to program options include strategies to enhance mental resilience with self-care techniques and connecting with licensed therapists for structured guidance.

We are preparing for the arrival of new dental and vision products to complement our existing Harvard Pilgrim health plan portfolio. Additional details will be available later this year. Product training sessions will be offered in early 2024 to our broker community.

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