Health Insurance

Health Insurance

Harvard Pilgrim Health Care

The Collaborative for Educational Services offers 3 plans from Harvard Pilgrim Health Care. To learn more about the plans and find the one that works best for you and your family click on the links below.

All of the Harvard Pilgrim Health Plans use the Value RX plan for prescription medications. With the Value RX plan, certain name brand medications are not covered, and some medications fall into a new tier in which members are charged a percentage of the cost instead of a fixed copay.

Although the Value formulary covers fewer drugs than some plans, it is important for you to know that FDA-approved alternatives will be available for all medications not covered. When generic equivalents are available, they will be offered in place of brand-name drugs.

If you would like to use a non-covered drug, you will be responsible for paying the full cost. In this situation, no payment will be made by Harvard Pilgrim. If your physician believes that there is no clinically appropriate drug in the Value formulary for the treatment of your condition, your physician may submit an exception request on your behalf.

Follow the links on each health plan page to learn more about the Value RX plans.

HMO 3000 Plan

The HMO plan has a $3,000 deductible per individual and a $6,000 deductible per family, however, CES offers HMO plan members a HRA (Health Reimbursement Account) which funds part of these deductible expenses.

For employees with a single plan, the employee pays the first $1,000 in deductible expenses, then CES funds the rest via the HRA. This means that CES may reimburse employees, with single coverage, up to $2,000.

For employees with 2-person or family plans, the employee pays the first $2,000 in deductible expenses, then CES funds the rest via the HRA. This means CES may reimburse employees with these levels of coverage up to $4,000.

What is an HRA?

HRA Claim Process

Click here to learn more about HMO 3000

 

Best Buy HSA PPO 2000/4000 and 3. Best Buy HSA PPO 3000/6000

The HSA PPO (High Deductible with HSA Feature) plans offer members greater flexibility and discretion when it comes to their health care. PPO plan members have the choice of using in-network or out-of-network providers and are not required to select a primary care physician, however, using in-network providers will save plan members money.

The PPO plans are subject to higher deductibles linked to prescriptions and services; therefore, it is highly encouraged that members also take advantage of an HSA (Health Savings Account). The HSA account is a great way to set aside funds for future medical expenses!

Click here to learn more about both HSA PPO Plans


Compare the 3 Plans

View the chart comparing plans

For more information, contact: 
Phone: 
413.586.4900 x5923 or x5925
Email: 
hr@collaborative.org