|Harvard Pilgrim HMO||Harvard Pilgrim PPO|
|Requires you to list a Primary Care Physician (PCP) from their wide network of doctors inside of MA and other New England states||Does not require you to list Primary Care Physician (PCP), you can see any doctor you choose|
|Must receive a referral from PCP to see a Specialist||No referral required to see a Specialist|
|Can be utilized in Emergency rooms and Urgent cares outside of MA||Can be utilized anywhere within the United States|
|You can find the Summary of Benefits here||You can find the Summary of Benefits here|
|Plans Offered||Individual HMO||Individual PPO||Family HMO||Family PPO|
|Monthly Premium Rate Cost||$214.32||$248.60||$549.64||$644.01|
|Tier 1 Co-Pay||$10||$20||$10||$20|
|Tier 2 Co-Pay||$20||$40||$20||$40|
|Tier 3 Co-Pay||$30||$60||$30||$60|
Employees who have Harvard Pilgrim Health Care insurance through the City of Malden are invited to participate in a points based program that allows them to earn point towards a $500 incentive that is deposited into a Health Reimbursement Account (HRA) Benny card that can be used to pay for out-of-pocket medical and dental expenses.
The program is designed to inspire you to take care of your physical, financial, emotional and work well-being. Participation in this program is optional, and the program is designed with a variety of wellness activities intended to improve overall health and well-being.
Due to the COVID-19 pandemic and the given social distancing guidelines and health care access, we want to ensure employees safely earn incentive dollars for participation in the Wellness Program, unfortunately, we will not be able to hold our usual Wellness Screenings to verify Biometrics (BMI, Blood Pressure and Cholesterol). In place of our screenings, Harvard Pilgrim has offered the alternative: Habit Builder Biometric Activities. Each Habit Builder is worth 100 points.