ICHRA Plan Information

Quoting can be done by signing into your HPHConnect Broker Portal and accessing the prompt for Individual/Medicare Enrollment; a prospective member can access information via the public site:

https://harvardpilgrim.force.com/members/memberCommunityHome

If you do not have broker portal access or have any questions, please contact your Individual Market Representative.

Applications can be entered by using your HPHConnect Broker Portal; prospects can enroll via the public website. It is important to use the designated ICHRA option when completing the enrollment.

Outside of Open Enrollment an Employer Attestation is required, which indicates that the employee has been offered an ICHRA.  If this is an enrollment for a new hire and not the initial enrollment for a whole group, we do request that the employee’s date of hire is included on the documentation to confirm eligibility for the requested effective date.

CMS.gov has a section on their website with templates that are acceptable forms of this attestation.

https://www.cms.gov/CCIIO/Programs-and-Initiatives/Health-Insurance-Market-Reforms/Health-Reimbursement-Arrangements

A Social security number is not required however it is encouraged for tax reporting purposes. Additionally, by providing a social security number the member will be able to easily set up a member portal account. If no social security number is provided the member will need to request a code online to set up a member portal account. The code will be sent by postal mail.

Approved applicants will receive an email that indicates their application is now in ‘Waiting Binder Payment’ status.  If you included your email in the additional email field, you will also receive this update.

Applicants will not be enrolled until they make their initial binder payment.

Applicants can:

• Pay on-line by using the link in the approval email or access “Complete Your Application” on the website https://harvardpilgrim.force.com/members/memberCommunityHome
• Call in to make a payment over the phone by using a checking or savings account withdrawal.
• Mail a check or money order in to:
  Harvard Pilgrim Health Care
  Premium Cash Dept. Wing B
  Attn: Individual Market
  1 Wellness Way
  Canton, MA 02021-1166

Mailed payments should include the Application ID number or the printed coupon from the online payment portal.

The binder payment is equivalent to one month’s premium if made before the effective date of coverage.  If the payment is made after the effective date, two months premium will be required.  Applications will not be processed for enrollment until the full premium amount due is made. The online payment portal will confirm the premium amount due.

An ICHRA is an individual account; therefore, the member is responsible for making the binder payment.

ID cards can be expected in the mail 7-10 days after the initial binder payment is made. If policy info is needed prior to receiving the cards the subscriber should be directed to contact Member services.

The relationship with an individual policy holder is between HPHC, the member and the Broker (if applicable).

Employers will not be able to make changes, call in for information or receive invoicing for members. This also applies to brokers who have used a Third Party Administrator (TPA).

NOTE: The member can choose to authorize another individual, including the employer or broker, to access their information (by completing a Member Authorization form) or to access their information and make changes (by completing a Designated Representative form).

These forms are available on the public website here or by calling Member Services: 1-877-907-4742.

If you are designated as the broker, you can contact Individual Market Member Services: 1-877-907-4742

Please note that Member Services can only answer general questions unless the member authorizes the release of their information by completing a Member Authorization form or Designated Representative form.

These forms are available on the public website here or by calling Member Services at the number listed above.

Yes, auto-pay is an option and can be set up when a binder payment is made or by using their member portal to set it up post enrollment. Auto-pay can take 1 to 2 billing cycles to take effect. Members should confirm with their invoice if a payment will be auto drafted or if a manual payment is required.

Please note that brokers are not permitted to access the member portal unless the member grants access by completing a Designated Representative form.

This form is available on the public website here or by calling Member Services: 1-877-907-4742.

The relationship with an individual policy holder is between the individual and HPHC; therefore, brokers and employers cannot facilitate changes to payment method unless the member authorizes the broker or employer by completing a Designated Representative form.

Brokers may assist member with this process by completing an Add Change Term Form and returning it to Member Services with supporting documentation.

Email: broker_member_inquiries@point32health.org