Tufts Health Plan and Harvard Pilgrim Health Care officially come together
View the press release
View our combined websiteTom Croswell to Retire as CEO of the combined organization of Tufts Health Plan and Harvard Pilgrim Health Care
Frequently Asked Questions
The new organization will strive to create a preeminent, nonprofit regional health services organization focused on improving affordability, increasing access to high quality health care, and enhancing member experience.
The newly combined organization serves close to 2.4 million members in Massachusetts, Maine, Connecticut, New Hampshire and Rhode Island; offering employer-sponsored plans, Medicare and Medicaid plans, Qualified Health Plans, and plans for those who are dually eligible for Medicare and Medicaid.
Below are frequently asked questions which will be updated as new information becomes available. Please check back here for most recent updates.
Why have Tufts Health Plan and Harvard Pilgrim combined? What value will the new organization bring to the marketplace?
Who is leading the new organization?
When will you have a name for the organization?
What happens now?
What can we expect from the new organization in 2021?
Is the newly combined organization anticipating savings from economies of scale?
What differences in operations will there be for clients in Connecticut, Maine, New Hampshire, and Rhode Island, where only one legacy brand is currently doing business?
Will inclusion and diversity still be important to the combined organization?
New Business Quotes and Renewals
How will quotes and renewals be handled, now that the transaction has closed?
I received a Tufts Health Plan or Harvard Pilgrim quote/renewal before the close for a 2021 effective date. Will that quote still be valid now that the companies have formally combined, or will you be issuing a new quote?
I received a Tufts Health Plan or Harvard Pilgrim quote/renewal before the close, for a 2021 effective date. Is that quote still valid now that the companies have formally combined?
What will happen with online access to make enrollment changes and get quotes for small group?
If a fully insured Tufts Health Plan customer wants to become self-funded, can they access Health Plans, Inc.?
How will RFPs be handled now that the companies have combined?
Will there be a change to the process for selling business through intermediaries?
For Massachusetts business, will my sales and account representative assignments change?
Will there be any impact to regional sales teams outside of Massachusetts?
Will the broker service model change?
For accounts that offer both Harvard Pilgrim and Tufts Health Plan, will there be any changes in service as a result of the combination?
Will account reporting or broker compensation tools change?
How will the day-to-day administration of plans be impacted?
If my client accepts the quote or renewal, to whom should they make the check payable?
Where do I send enrollment information? Harvard Pilgrim and Tufts Health Plan have different due dates. Which date is applicable?
Rates and Underwriting
Will the underwriting approach or rules change now that the combination is complete? Will there be separate or unified rates?
If I have separate quotes from each organization, can I pick the best one?
How will premiums be impacted by the combination?
Products and Offerings
Are there any limitations on either Tufts Health Plan or Harvard Pilgrim plans available since the combination?
How long will Harvard Pilgrim and Tufts Health Plan products be available for renewals?
In New Hampshire, will the combined organization now offer both Harvard Pilgrim and Tufts Health Freedom Plan commercial products?
In Connecticut, what is the relationship with Hartford Healthcare and CarePartners of Connecticut as it relates to this combination?
Where does Tufts Health Direct fit into the product strategy?
Will you be offering individual medical plans in all states?
Will the Tufts Health Plan or Harvard Pilgrim provider networks change?
How will the combined organization handle merging the networks and provider contracts?
Which national provider network will the new organization use?
Will there be changes in pharmacy benefit managers (PBMs)?
Will there be changes in the care management model?
Will there be changes to the behavioral health models or vendors?
Will there be changes to ancillary partners?
When and how will you integrate the wellness offerings?
What operating platform will the newly combined organization use for commercial products, and what is the timeline for transition?
Will Tufts Health Plan products be eliminated when the organization transitions to the Harvard Pilgrim platform?
What if I have a client who wants to remain on the Tufts Health Plan platform?
Will there be any member impact at date of close?
What will happen to my 2021 broker compensation program?
Information about Medicare Business
Will Tufts Health Plan be allowing brokers to sell Massachusetts plans in the future?
What is going to happen to my current Medicare book of business?
If my Medicare book moves to Tufts Health Plan, will I remain as the broker of record?
If my Medicare book moves, will I continue to receive renewal commissions?
Can I sell both Tufts Health Plan and Harvard Pilgrim Medicare products?
Will I receive an agency override on Tufts Health Plan business?
I am a broker selling Medicare products in New Hampshire/Maine. How am I affected?
How do I “sell” the combination to my clients, if they ask what the implications are for them?
Will there be a stronger focus on the success of the Medicare health plans between the companies in Maine, New Hampshire and Massachusetts?