On Jan. 1, 2019, Harvard Pilgrim is introducing a new family of commercial POS and HMO products for fully insured large groups (100+ employees) in Maine, known as POS and HMO Open Access plans.
These plans provide a new option for the large group market that features the best aspects of Harvard Pilgrim’s existing HMO and PPO products. They will offer members the ease and flexibility of a PPO, with no requirement for referrals, along with affordability.
Although referrals will not be needed for POS or HMO Open Access plans, members will still be required to select a Harvard Pilgrim primary care physician — to continue Harvard Pilgrim’s focus on care coordination and care management and emphasize the doctor-patient relationship.
We will offer four base plan designs: Open Access POS, Open Access POS HSA, Open Access HMO, and Open Access HMO HSA.
You can recognize members of these plans by their Harvard Pilgrim member ID cards.
Provider directory and plan information
Open Access POS and Open Access POS HSA members will use the “POS/POS Open Access” provider directory, and Open Access HMO and Open Access HMO HSA members will use the “HMO/HMO Open Access” directory. For more information about participating providers, please refer to Harvard Pilgrim’s online provider directory
or in HPHConnect.
For more information, please refer to the Open Access POS and Open Access HMO product pages in Harvard Pilgrim’s commercial Provider Manual.