Merger Between Tufts Health Plan and Harvard Pilgrim Health Care
Tufts Health Plan and Harvard Pilgrim Health Care are now combined into a single health and well-being organization: Point 32 Health. The following outlines important information about the transition.
New Medical Plan Names
Refer to the table below to see the new medical plan names under Harvard Pilgrim Health Care.
Service | 2023 | 2024 | Change |
---|---|---|---|
Vendor | Tufts | HPHC | New Vendor |
Medical Plan | n/a | Best Buy HMO HSA | New Plan |
Medical Plan | EPO Value Deductible | Best Buy HMO | Same Plan |
Medical Plan | EPO Premium | HMO | Same Plan |
Medical Plan | PPO | PPO | Same Plan |
Nationwide Network | CIGNA | United Health Care | New Provider Network |
Virtual Health Care | Teledoc | Doctor On Demand | New Provider Network |
Basic Eye Care | EyeMed | HPHC provider network | New Network |
Pediatric Dental | Delta Dental | HPHC provider network | New Network |
Pharmacy Admin | OptumRx | OptumRx | Same Provider |
Behavioral Health | Tuft Network of Providers | HPHC Network of Providers |
Merger Updates
January 1, 2024 - Transition from Tufts Health Plan to Harvard Pilgrim Health Care (HPHC)
As we previously communicated in a letter from Vice President Robin Switzer, Tufts Health Plan and Harvard Pilgrim Health Care are now combined into a single health and well-being organization: Point 32 Health. There are several important transitional items that you need to be aware of:
- As of January 1, 2024, your current Tufts Health Plan will transition to Harvard Pilgrim Health Care.
- Participants will receive new member ID cards effective 1/1/2024 with the HPHC logo and new group and subscriber ID numbers.
- MyConnect, (866-623-0184) is a Member Advocate service that is your direct connection to HPHC for assistance with questions about your coverage.
- If you are actively receiving care from a Tufts Health Plan provider who is not available as a HPHC provider, you will be able to continue receiving care from this provider for 90 days or through March 31st, 2024, whichever is greater. HPHC is actively pursuing these providers to come to HPHC.
- As HPHC members, you will continue to have access to a robust New England network of providers, with nearly 80,000 doctors and specialists and 153 hospitals, including a broad network of behavioral health providers and services.
- For PPO participants, a national network provided by UnitedHealthCare (formerly CIGNA) with access to more than 1.5 million providers nation-wide.
- Telehealth services through 'Doctor on Demand' for 24/7 virtual urgent care and Behavioral Health needs.
January 1, 2021 - Harvard Pilgrim Health Care and Tufts Health Plan Merger
The combination of Tufts Health Plan and Harvard Pilgrim Health Care represents the coming together of two of New England’s most iconic nonprofit health care companies. Representing nearly 90 years of combined service to our members and the community, together we are building upon our diverse legacies and innovative collaboration by making it our purpose to guide and empower healthier lives for everyone — no matter their age, health, race, identity, or income.
That’s why we’ve named our new corporate entity Point32Health. The Point32Health name is inspired by the 32 points on a compass. It speaks to the critical role we play in guiding and empowering the people we serve to achieve healthier lives.
Point32Health is our corporate name. Harvard Pilgrim Health Care, Tufts Health Plan and our other brands will continue to show up as they do today—trusted, high-quality health plans for people across the country.
As Point32Health, we strive to be a different kind of nonprofit health and well-being company, with a broad range of health plans, and innovative tools that make navigating health and well-being easier, guiding our members at every step of their health care journey to better health outcomes. We are committed to providing high-quality and affordable health care, improving the health and wellness of our members, and creating healthier communities across the country.
August 2019 - Tufts Health Plan and Harvard Pilgrim Health Care Announced Intent to Combine Organizations
We have been assured that at this time there will be no impact on existing relationships, contracts, networks, pricing, etc. There will be no disruption to you or your dependents; you will continue to have the same coverage and excellent service you have become accustomed to.
Plan officials have said it will be “business as usual” until at least sometime between the second and third quarter of 2020 as a review process takes place. This merger still needs state and regulatory approval, which can take up to one year or more. During this period, the two organizations remain separate and distinct — and competitors.
If you have questions, please call the toll-free number on the back of your insurance card: 877-658-3630. Please do not hesitate to reach out to the benefits unit with questions or concerns.
Our Health Care Partners: Who They Are and What They Do
Point32Health
Point32Health is the parent company of the merger between two primary health plan companies in MA. These two health plan companies are now one well-being company but still maintain the two plans which have different customer bases. HPHC is for commercial customers (like Brandeis). Tufts is for government related customers like MassHealth and Medicare. Negotiates contracts with Physicians and physician networks to provide in-network coverage for members.
edHealth
EdHealth is a group of higher ed and secondary schools that pooled together to purchase health insurance and related health insurance and risk management products. It creates a larger claim pool which reduces costs and helps smaller schools to be able to offer affordable insurance for members.
EdHealth negotiates with the HPHC for the different versions of plan options; two or three types of PPO’s HMO’s HDHP’s for Brandeis to choose from to offer their employees. It also negotiates the annual overall rates for each employer based on claims experience, high claimant stop-loss coverage and general overall trend for the year.
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Contact the Benefits Team
Email the Human Resources Benefits Team at benefits@brandeis.edu.