Our Solutions
Select a state first (BY STATE), followed by group type (BY GROUP). Then choose a specific plan type (BY PLAN). To compare multiple plans at once, see the new plan compare tool.
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For groups with up to 50 FTE. Full, tiered and select network plan options to suit employers’ needs.
Small Group Enrollment Hub
Harvard Pilgrim will no longer sell plans for small group businesses (those with fewer than 50 members) in Rhode Island as of July 1, 2025. Employers and members who currently have Rhode Island small group policies will be covered through the end of their plan year but will not be able to renew their Harvard Pilgrim coverage in 2026.
Small Group Enrollment Hub
Harvard Pilgrim will no longer sell plans for small group businesses (those with fewer than 50 members) in Rhode Island as of July 1, 2025. Employers and members who currently have Rhode Island small group policies will be covered through the end of their plan year but will not be able to renew their Harvard Pilgrim coverage in 2026.
| Plan Name | Year | Overview | Documents |
|---|---|---|---|
| HMO Flex | 202320242025 | Provides access to our full network of New England providers and hospitals. PCPs and referrals are required. Flex benefit provides member savings on general labs and outpatient surgery. | HMO BrochureFlex Flyer |
| HMO HSA Flex | 202320242025 | A qualified high-deductible health plan (HDHP). Provides access to our full network of New England providers and hospitals. PCPs and referrals are required. Flex benefit provides member savings on general labs and outpatient surgery. Gives employers and/or members the option to fund a health savings account. | HMO HSA BrochureFlex Flyer |
| Focus Network-MA HMO | 202320242025 | A select network HMO. Members must use Focus Network-MA hospitals and providers, except in medical emergencies. PCPs and referrals are required. Lower premiums compared to full-network plans. | MA Focus Network HMO BrochureMA HMO Focus Hospital List |
| Focus Network-MA HMO HSA | 202320242025 | A select network HMO and qualified high-deductible health plan (HDHP). Members must use Focus Network-MA hospitals and providers, except in medical emergencies. PCPs and referrals are required. Gives employers and/or members the option to fund a health savings account. Lower premiums compared to full-network plans. | MA Focus Network HMO HSA BrochureMA HMO Focus Hospital List |
| Standard Connector HMO | 202320242025 | An HMO with three-tier value formulary Rx coverage. Available on and off the Connector. Provides access to our full network of New England providers and hospitals. PCPs and referrals are required. | HMO Brochure |
| Standard Connector HMO Flex | 202320242025 | An HMO with three-tier value formulary Rx coverage. Available on and off the Connector. Provides access to our full network of New England providers and hospitals. PCPs and referrals are required. Flex benefit provides member savings on general labs and outpatient surgery. | HMO BrochureFlex Flyer |
| Standard Connector HMO HSA Flex | 202320242025 | An HMO with three-tier value formulary Rx coverage and a qualified high-deductible health plan (HDHP). Available on and off the Connector. Provides access to our full network of New England providers and hospitals. PCPs and referrals are required. Flex benefit provides member savings on general labs and outpatient surgery. | HMO HSA BrochureFlex Flyer |
Benefits, coverage and member cost-sharing details for our plans.
Schedules of Benefits and SBCs: Massachusetts
Individual 2024
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum - Flex MD0000201122 | Show Standard Platinum - Flex SOB | Show Standard Platinum - Flex SBC |
| Standard High Gold MD0000201116 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard High Bronze HSA - Flex MD0000201126 | Show Standard High Bronze HSA - Flex SOB | Show Standard High Bronze HSA - Flex SBC |
| HMO 2000 Low - Flex MD0000201123 | Show HMO 2000 Low - Flex SOB | Show HMO 2000 Low - Flex SBC |
| HMO 3500 - Flex MD0000201124 | Show HMO 3500 - Flex SOB | Show HMO 3500 - Flex SBC |
| Standard Silver II MD0000201164 | Show Standard Silver II SOB | Show Standard Silver II SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - Limited | SOB | SBC |
|---|---|---|
| Standard Platinum - Flex MD0000201122 | Show Standard Platinum - Flex SOB | Show Standard Platinum - Flex SBC |
| Standard High Gold MD0000201116 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard High Bronze HSA - Flex MD0000201126 | Show Standard High Bronze HSA - Flex SOB | Show Standard High Bronze HSA - Flex SBC |
| HMO 2000 Low - Flex MD0000201123 | Show HMO 2000 Low - Flex SOB | Show HMO 2000 Low - Flex SBC |
| HMO 3500 - Flex MD0000201124 | Show HMO 3500 - Flex SOB | Show HMO 3500 - Flex SBC |
| Standard Silver II MD0000201164 | Show Standard Silver II SOB | Show Standard Silver II SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - $0 Cost | SOB | SBC |
|---|---|---|
| HMO MD0000201115 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201115 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201115 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201115 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201115 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201115 | Show HMO SOB | Show HMO SBC |
| HMO - ON EXCHANGE with Dental - CSR - 94% | SOB | SBC |
|---|---|---|
| Standard ConnectorCare 1 MD0000201118 | Show Standard ConnectorCare 1 SOB | Show Standard ConnectorCare 1 SBC |
| HMO - ON EXCHANGE with Dental - CSR - 87% | SOB | SBC |
|---|---|---|
| Standard ConnectorCare 2 MD0000201119 | Show Standard ConnectorCare 2 SOB | Show Standard ConnectorCare 2 SBC |
| HMO - ON EXCHANGE with Dental - CSR - 73% | SOB | SBC |
|---|---|---|
| Standard ConnectorCare 3 MD0000201120 | Show Standard ConnectorCare 3 SOB | Show Standard ConnectorCare 3 SBC |
Individual 2025
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum - Flex MD0000201392 | Show Standard Platinum - Flex SOB | Show Standard Platinum - Flex SBC |
| Standard High Gold MD0000201393 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Silver II MD0000201395 | Show Standard Silver II SOB | Show Standard Silver II SBC |
| Standard High Bronze HSA - Flex MD0000201398 | Show Standard High Bronze HSA - Flex SOB | Show Standard High Bronze HSA - Flex SBC |
| HMO 2000 Value II - Flex MD0000201399 | Show HMO 2000 Value II - Flex SOB | Show HMO 2000 Value II - Flex SBC |
| HMO 3500 - Flex MD0000201401 | Show HMO 3500 - Flex SOB | Show HMO 3500 - Flex SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - Limited | SOB | SBC |
|---|---|---|
| Standard Platinum - Flex MD0000201392 | Show Standard Platinum - Flex SOB | Show Standard Platinum - Flex SBC |
| Standard High Gold MD0000201393 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Silver II MD0000201395 | Show Standard Silver II SOB | Show Standard Silver II SBC |
| Standard High Bronze - Flex MD0000201402 | Show Standard High Bronze - Flex SOB | Show Standard High Bronze - Flex SBC |
| HMO 2000 Value II - Flex MD0000201399 | Show HMO 2000 Value II - Flex SOB | Show HMO 2000 Value II - Flex SBC |
| HMO 3500 - Flex MD0000201401 | Show HMO 3500 - Flex SOB | Show HMO 3500 - Flex SBC |
| HMO - ON EXCHANGE with Dental - AI/AN - $0 | SOB | SBC |
|---|---|---|
| HMO MD0000201412 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201412 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201412 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201412 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201412 | Show HMO SOB | Show HMO SBC |
| HMO MD0000201412 | Show HMO SOB | Show HMO SBC |
| HMO - ON EXCHANGE with Dental - CSR - 94% | SOB | SBC |
|---|---|---|
| Standard ConnectorCare 1 MD0000201413 | Show Standard ConnectorCare 1 SOB | Show Standard ConnectorCare 1 SBC |
| HMO - ON EXCHANGE with Dental - CSR - 87% | SOB | SBC |
|---|---|---|
| Standard ConnectorCare 2 MD0000201396 | Show Standard ConnectorCare 2 SOB | Show Standard ConnectorCare 2 SBC |
| HMO - ON EXCHANGE with Dental - CSR - 73% | SOB | SBC |
|---|---|---|
| Standard ConnectorCare 3 MD0000201397 | Show Standard ConnectorCare 3 SOB | Show Standard ConnectorCare 3 SBC |
Small Group 2024
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum - Flex MD0000201122 | Show Standard Platinum - Flex SOB | Show Standard Platinum - Flex SBC |
| Standard High Gold MD0000201116 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Silver MD0000201117 | Show Standard Silver SOB | Show Standard Silver SBC |
| Standard Low Silver HSA - Flex MD0000201125 | Show Standard Low Silver HSA - Flex SOB | Show Standard Low Silver HSA - Flex SBC |
| Standard High Bronze HSA - Flex MD0000201126 | Show Standard High Bronze HSA - Flex SOB | Show Standard High Bronze HSA - Flex SBC |
| HMO 2000 Low - Flex MD0000201123 | Show HMO 2000 Low - Flex SOB | Show HMO 2000 Low - Flex SBC |
| HMO 3500 - Flex MD0000201124 | Show HMO 3500 - Flex SOB | Show HMO 3500 - Flex SBC |
| PPO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| PPO HSA 2000 - Flex MD0000201127 | Show PPO HSA 2000 - Flex SOB | Show PPO HSA 2000 - Flex SBC |
Small Group 2025
| HMO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| Standard Platinum - Flex MD0000201392 | Show Standard Platinum - Flex SOB | Show Standard Platinum - Flex SBC |
| Standard High Gold MD0000201393 | Show Standard High Gold SOB | Show Standard High Gold SBC |
| Standard Silver MD0000201394 | Show Standard Silver SOB | Show Standard Silver SBC |
| Standard Low Silver HSA - Flex MD0000201404 | Show Standard Low Silver HSA - Flex SOB | Show Standard Low Silver HSA - Flex SBC |
| Standard High Bronze HSA - Flex MD0000201398 | Show Standard High Bronze HSA - Flex SOB | Show Standard High Bronze HSA - Flex SBC |
| HMO 2000 Value II - Flex MD0000201399 | Show HMO 2000 Value II - Flex SOB | Show HMO 2000 Value II - Flex SBC |
| HMO 3500 - Flex MD0000201401 | Show HMO 3500 - Flex SOB | Show HMO 3500 - Flex SBC |
| PPO - ON EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| PPO HSA 2000 - Flex MD0000201400 | Show PPO HSA 2000 - Flex SOB | Show PPO HSA 2000 - Flex SBC |
Offerings that enhance our value for members, employers and brokers. Fees may apply to some programs.
Medical, Pharmacy and Health Services
Transparency tools, pharmacy information and other resources for when members need guidance with their care.
Pharmacy Program
We offer a variety of tiered formulary offerings to meet your clients’ needs.
Urgent Care Options and ER Alternatives
When their PCPs aren’t available, members who need care right away for minor illnesses and accidents have a variety of cost-effective options.
Member Savings
Programs for helping members keep more of their money.
Fitness Reimbursement Benefits
We know the value that a healthy workforce brings to your clients. So, to guide and support employee well-being, we offer fitness reimbursements of up to $150-$300 a year for our members.
Estimate My Cost
This search tool lets members find and compare estimated health care costs before they receive services. It’s available to members in CT, MA, ME and NH.
Additional Products & Programs
HSAs and HRAs
HSAs and HRAs can offset the costs of high-deductible health plans and motivate members to make smarter health care decisions. Our preferred vendors can get you and your clients started.