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.
- Switch View to Plan Descriptions
- Switch View to Schedule of Benefits & SBCs
- Switch View to Services, Tools & Programs
| Plan Name | Year | Overview | Documents |
|---|---|---|---|
| HMO | 202220232024 | Provides access to our full network of New England providers and hospitals. PCPs and referrals are required. | HMO Brochure |
| HMO – LP | 202220232024 | Provides access to our full network of New England providers and hospitals. PCPs are required; referrals are not. With the LP benefit, members can pay lower cost sharing when they use Select LP Providers for lab services and outpatient surgery. | HMO Brochure |
| HMO HSA with Preventive RX | 202220232024 | A qualified high-deductible health plan (HDHP). Provides access to our full network of New England providers and hospitals. PCPs are required; referrals are not. Gives employers and/or members the option to fund a health savings account. Members can buy certain preventive drugs without having to pay deductible costs. | HMO HSA Brochure |
| ElevateHealth HMO | 202220232024 | Select network HMO. Members must use ElevateHealth hospitals and providers, except in medical emergencies. PCPs and referrals are required. | NH ElevateHealth HMO Brochure ElevateHealth Network Map |
| ElevateHealth HMO HSA with Preventive RX | 202220232024 | A select network HMO and qualilfied high deductible health plan (HDHP). Members must use ElevateHealth 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. Members can buy certain preventive drugs without having to pay deductible costs. | ElevateHealth HMO HSA BrochureElevateHealth Network Map |
| ElevateHealth Options HMO | 202220232024 | A tiered HMO that provides access to our select ElevateHealth network for lower out-of-pocket costs and the rest of our New England network for higher out-of-pocket costs. PCPs and referrals are required. | NH ElevateHealth Options HMO BrochureElevateHealth Network Map |
| PPO – LP | 202220232024 | Provides in-network access to local and national providers and hospitals, and out-of-network access to non-participating providers. No PCPs or referrals are required. With the LP benefit, members can pay lower cost sharing when they use Select LP Providers for lab services and outpatient surgery. | PPO Brochure |
| PPO HSA with Preventive Rx | 202220232024 | A qualified high-deductible health plan (HDHP). Provides in-network access to local and national providers and hospitals, and out-of-network access to non-participating providers. No PCPs or referrals are required. Gives employers and/or members the option to fund a health savings account. Members can buy certain preventive drugs without having to pay deductible costs. | PPO HSA Brochure |
| SimplyVirtualSM HMO | 202220232024 | Full-network virtual PCP plan. PCPs and referrals are required. Members age 19 and up choose Doctor On Demand PCPs; members under age 19 choose office-based PCPs. Doctor On Demand PCPs refer members to office-based providers in Harvard Pilgrim’s network for services that can't be provided virtually (e.g., specialty care, labs, X-rays). | SimplyVirtual Member Flyer |
Benefits, coverage and member cost-sharing details for our plans.
Schedules of Benefits and SBCs: New Hampshire
Individual 2023
| HMO - ON EXCHANGE without Dental - CSR - 73% | SOB | SBC |
|---|---|---|
| NH Local Choice HMO Silver 2500 MD0000200133 | Show NH Local Choice HMO Silver 2500 SOB | Show NH Local Choice HMO Silver 2500 SBC |
| NH Local Choice HMO Silver 3500 MD0000200141 | Show NH Local Choice HMO Silver 3500 SOB | Show NH Local Choice HMO Silver 3500 SBC |
| NH Local Choice HMO Silver 4000 MD0000200144 | Show NH Local Choice HMO Silver 4000 SOB | Show NH Local Choice HMO Silver 4000 SBC |
| NH Local Choice HMO Silver 5000 MD0000200147 | Show NH Local Choice HMO Silver 5000 SOB | Show NH Local Choice HMO Silver 5000 SBC |
| NH Local Choice HMO Silver 3500 MD0000200151 | Show NH Local Choice HMO Silver 3500 SOB | Show NH Local Choice HMO Silver 3500 SBC |
| NH Local HMO Silver 5800 Standard MD0000200246 | Show NH Local HMO Silver 5800 Standard SOB | Show NH Local HMO Silver 5800 Standard SBC |
| HMO - ON EXCHANGE without Dental - CSR - 87% | SOB | SBC |
|---|---|---|
| NH Local Choice HMO Silver 2500 MD0000200134 | Show NH Local Choice HMO Silver 2500 SOB | Show NH Local Choice HMO Silver 2500 SBC |
| NH Local Choice HMO Silver 3500 MD0000200142 | Show NH Local Choice HMO Silver 3500 SOB | Show NH Local Choice HMO Silver 3500 SBC |
| NH Local Choice HMO Silver 4000 MD0000200145 | Show NH Local Choice HMO Silver 4000 SOB | Show NH Local Choice HMO Silver 4000 SBC |
| NH Local Choice HMO Silver 5000 MD0000200148 | Show NH Local Choice HMO Silver 5000 SOB | Show NH Local Choice HMO Silver 5000 SBC |
| NH Local Choice HMO Silver 3500 MD0000200156 | Show NH Local Choice HMO Silver 3500 SOB | Show NH Local Choice HMO Silver 3500 SBC |
| NH Local HMO Silver 5800 Standard MD0000200247 | Show NH Local HMO Silver 5800 Standard SOB | Show NH Local HMO Silver 5800 Standard SBC |
| HMO - ON EXCHANGE without Dental - CSR - 94% | SOB | SBC |
|---|---|---|
| NH Local Choice HMO Silver 2500 MD0000200140 | Show NH Local Choice HMO Silver 2500 SOB | Show NH Local Choice HMO Silver 2500 SBC |
| NH Local Choice HMO Silver 3500 MD0000200143 | Show NH Local Choice HMO Silver 3500 SOB | Show NH Local Choice HMO Silver 3500 SBC |
| NH Local Choice HMO Silver 4000 MD0000200146 | Show NH Local Choice HMO Silver 4000 SOB | Show NH Local Choice HMO Silver 4000 SBC |
| NH Local Choice HMO Silver 5000 MD0000200149 | Show NH Local Choice HMO Silver 5000 SOB | Show NH Local Choice HMO Silver 5000 SBC |
| NH Local Choice HMO Silver 3500 MD0000200158 | Show NH Local Choice HMO Silver 3500 SOB | Show NH Local Choice HMO Silver 3500 SBC |
| NH Local HMO Silver 5800 Standard MD0000200248 | Show NH Local HMO Silver 5800 Standard SOB | Show NH Local HMO Silver 5800 Standard SBC |
Individual 2024
| HMO - ON EXCHANGE without Dental - CSR - 73% | SOB | SBC |
|---|---|---|
| NH Local Choice HMO Silver 2500 CSR73 MD0000201038 | Show NH Local Choice HMO Silver 2500 CSR73 SOB | Show NH Local Choice HMO Silver 2500 CSR73 SBC |
| NH Local Choice HMO Silver 3000 CSR73 MD0000201031 | Show NH Local Choice HMO Silver 3000 CSR73 SOB | Show NH Local Choice HMO Silver 3000 CSR73 SBC |
| NH Local Choice HMO Silver 2800 CSR73 MD0000201048 | Show NH Local Choice HMO Silver 2800 CSR73 SOB | Show NH Local Choice HMO Silver 2800 CSR73 SBC |
| NH Local Choice HMO Silver 3400 CSR73 MD0000201029 | Show NH Local Choice HMO Silver 3400 CSR73 SOB | Show NH Local Choice HMO Silver 3400 CSR73 SBC |
| NH Local HMO Silver 5700 Standard CSR73 MD0000201044 | Show NH Local HMO Silver 5700 Standard CSR73 SOB | Show NH Local HMO Silver 5700 Standard CSR73 SBC |
| HMO - ON EXCHANGE without Dental - CSR - 87% | SOB | SBC |
|---|---|---|
| NH Local Choice HMO Silver 1000 CSR87 MD0000201037 | Show NH Local Choice HMO Silver 1000 CSR87 SOB | Show NH Local Choice HMO Silver 1000 CSR87 SBC |
| NH Local Choice HMO Silver Copay 1200 CSR87 MD0000201046 | Show NH Local Choice HMO Silver Copay 1200 CSR87 SOB | Show NH Local Choice HMO Silver Copay 1200 CSR87 SBC |
| NH Local Choice HMO Silver 1100 CSR87 MD0000201050 | Show NH Local Choice HMO Silver 1100 CSR87 SOB | Show NH Local Choice HMO Silver 1100 CSR87 SBC |
| NH Local Choice HMO Silver 1400 CSR87 MD0000201049 | Show NH Local Choice HMO Silver 1400 CSR87 SOB | Show NH Local Choice HMO Silver 1400 CSR87 SBC |
| NH Local HMO Silver 700 Standard CSR87 MD0000201045 | Show NH Local HMO Silver 700 Standard CSR87 SOB | Show NH Local HMO Silver 700 Standard CSR87 SBC |
| HMO - ON EXCHANGE without Dental - CSR - 94% | SOB | SBC |
|---|---|---|
| NH Local Choice HMO Silver 300 CSR94 MD0000201036 | Show NH Local Choice HMO Silver 300 CSR94 SOB | Show NH Local Choice HMO Silver 300 CSR94 SBC |
| NH Local Choice HMO Silver Copay 400 CSR94 MD0000201035 | Show NH Local Choice HMO Silver Copay 400 CSR94 SOB | Show NH Local Choice HMO Silver Copay 400 CSR94 SBC |
| NH Local Choice HMO Silver 350 CSR94 MD0000201033 | Show NH Local Choice HMO Silver 350 CSR94 SOB | Show NH Local Choice HMO Silver 350 CSR94 SBC |
| NH Local Choice HMO Silver 450 CSR94 MD0000201051 | Show NH Local Choice HMO Silver 450 CSR94 SOB | Show NH Local Choice HMO Silver 450 CSR94 SBC |
| NH Local HMO Silver Standard CSR94 MD0000201047 | Show NH Local HMO Silver Standard CSR94 SOB | Show NH Local HMO Silver Standard CSR94 SBC |
Small Group 2023
Small Group 2024
| NRH - OFF EXCHANGE with Dental | SOB | SBC |
|---|---|---|
| HMO Platinum 250 - LP Open Access MD0000201100 | Show HMO Platinum 250 - LP Open Access SOB | Show HMO Platinum 250 - LP Open Access SBC |
| HMO Gold 2500 - LP Open Access with Rx Deductible MD0000201101 | Show HMO Gold 2500 - LP Open Access with Rx Deductible SOB | Show HMO Gold 2500 - LP Open Access with Rx Deductible SBC |
| HMO Silver 3500 - LP Open Access with Rx Deductible MD0000201102 | Show HMO Silver 3500 - LP Open Access with Rx Deductible SOB | Show HMO Silver 3500 - LP Open Access with Rx Deductible SBC |
| HMO Silver 4500 - LP Open Access with Rx Deductible MD0000201103 | Show HMO Silver 4500 - LP Open Access with Rx Deductible SOB | Show HMO Silver 4500 - LP Open Access with Rx Deductible 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.
Health Services
HMO, PPO
We’re proud to offer our members a diverse menu of well-being offerings but we also know it’s a lot to unpack. Discover a resource that puts all these services in one place. Our Health Services Cheat Sheet easily differentiates one offering from another and gives you access to the talking points that will speak to your client. Find information on dozens of services now available to fully insured and self-insured members in an easy to digest format that cuts through the noise.
Emergency Room Cost Sharing
HMO, PPO
Starting with 2019 renewals, members on our New Hampshire plans will pay higher cost sharing for emergency room (ER) visits that are not considered medical emergencies. We will not deny any claims based on the reason for a member’s ER visit.
Pharmacy Program
HMO, PPO
We offer a variety of tiered formulary offerings to meet your clients’ needs.
Urgent Care Options and ER Alternatives
HMO, PPO
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
HMO, PPO
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
HMO, PPO
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.
Reduce My Costs
HMO, PPO
Voluntary program that makes it easy for members to save money by finding care at lower-cost facilities for elective, outpatient medical procedures and diagnostic tests. Members can earn rewards for choosing lower-cost providers.
Additional Products & Programs
Guardian
HMO, PPO
Harvard Pilgrim and Guardian are partnering to provide a full line of ancillary insurance products – including dental, vision, short- and long-term disability and more – to employers in Maine, Massachusetts and New Hampshire. Learn how your clients can save money and provide more insurance options for their employees.
HSAs and HRAs
HMO, PPO
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.
Population Health
Care Management
HMO, PPO
As industry leaders in population health, we combine data and analytics with robust care-management outreach. Our “Whole person, In Person” approach to care encourages wellness and contains costs.