The Employer Account is our way to help employers manage health care administration faster, more accurately and more conveniently. This web-based service will allow you to download a roster, verify new enrollees, edit/add/disenroll subscribers and more.
Once the employer group approves a transaction and receives a confirmation number, it’s processed in real time, ensuring a timely and accurate enrollment experience for the member.
Employers are able to change PCP information; however, it is recommended the members change their PCP at any time using their Member Secure Account at harvardpilgrim.org. We encourage members to call Member Services directly to ensure they know the impacts of making a PCP change, such as new referrals and potential claim issues.
Select the “terminate the subscriber contract” link at the bottom of the Enrollment Summary screen allows you to disenroll the subscriber (including all dependents) from Harvard Pilgrim coverage. Please enter the last day of coverage.
Our standard method of enrollment is the Employer Account (our secure Web- based enrollment tool), which performs online validation to prevent the submission of incomplete or inaccurate enrollment transactions. The Employer Account provides faster processing time and improved service to our employers and their employees.
We also offer Electronic Data Interchange (used by employers to submit batch enrollment transactions electronically) when approved and a Harvard Pilgrim paper enrollment/ change form as other enrollment method options.
Adding/changing
Notification of an enrollment, re-enrollment or change request needs to be received within 60 days of the qualified effective date. If the request is more than 60 days after the effective date, coverage will be denied and the requester must wait for another qualifying event or next open enrollment period for further consideration.
Terminating
Notification of enrollment terminations must be received within 60 calendar days of the requested termination date.
* If notice of a termination is received more than 60 days after the requested termination date, the termination date will be automatically processed 60 days retroactively, beginning on the date the request was received by Harvard Pilgrim.
* For New Hampshire employers, terminations may be processed no more than 30 days from the date the termination request is received, in accordance with state requirements.
Coverage remains active through 11:59 pm on the member’s termination date. There is no coverage for any services received on or after midnight following on the date a member’s termination date. All authorizations for services issued by Harvard Pilgrim or participating providers assume confirmation of membership and are invalid after termination of membership including retroactive terminations.
Harvard Pilgrim provides a free online billing service to employer groups via the Employer Account. Online billing allows you to manage your invoice in a secure environment, making bill payment quicker, easier and more accurate.
With online billing, you will receive a preliminary bill on or about the 10th of each month. This provides you with a “preview” of what your next month’s bill will look like, allowing you to focus on any adjustments that need to be made.
Harvard Pilgrim online billing also lets you select a final bill (15th or 25th) date to align with your business processes. The final bill will reflect your premium due based on all membership changes made since your preliminary bill was presented.
For more information about online billing, please contact the Broker/Employer Account Services Department Team at 800-637-4751.
If an employer group is unable to receive invoices online through the Employer Account, Harvard Pilgrim will provide a paper bill each month and mail it approximately 15 days before the payment due date. Full premium payment is due on the first of the month for that coverage month (i.e. payment due by May 1st for the month of May).
Please forward a check, along with the printed coupon from the summary page of your online or paper invoice.
Harvard Pilgrim Health Care
PO Box 970050
Boston, MA 02297-0050
The following methods may be used to remit your premium payments:
- Check: Harvard Pilgrim uses an automated lock box service to ensure accurate and timely processing of your payment. When paying for multiple divisions with the same check, please include a separate coupon for each division and indicate the amount to be applied to each division.
- Electronic Funds Transfer through online billing.
- Harvard Pilgrim also accepts premium payments electronically by wire or Automatic Clearinghouse (ACH) transfer.