Early Retirees and Non-Medicare Eligible Retirees

Early Retirees and Non-Medicare Eligible Retirees Benefits 07/01/2024 - 06/30/2025
HARVARD PILGRIM HEALTH CARE (3 Plans):

Harvard Pilgrim Focus Network MA HMO

Medical Plan Monthly Contribution 07/01/2024: Individual $1,032.62 Family $2,713.73
*Focus Network MA HMO Flyer
*Focus Network MA HMO Summary of Benefits and Coverage
*Focus Network MA HMO Schedule of Benefits
*Focus Network MA HMO Prescription Coverage

Harvard Pilgrim HMO

Medical Plan Monthly Contribution 07/01/2024:  Individual  $1,134.57 Family $2,981.65
*HMO Summary of Benefits and Coverage
*HMO Schedule of Benefits
*HMO Prescription Coverage

 

Harvard Pilgrim PPO (option only if you live outside of the New England area)

Medical Plan Monthly Contribution 07/01/2024:  Individual $1,204.74 Family $3,166.06

*PPO Summary of Benefits and Coverage
*PPO Schedule of Benefits
*PPO Prescription Coverage

Harvard Pilgrim Enrollment Form:

*Harvard Pilgrim Enrollment Form

Disclosure Notice:
*Medicare Part D Creditable Coverage Disclosure Notice

ALTUS DENTAL:
*Altus Dental Benefits Summary Low Plan
*Altus Dental Benefits Summary High Plan
*Altus Preventive Rewards Flyer

*Altus Dental PreTreatment

*Altus Web Flyer
*Altus Dental Enrollment Form

ALTUS VISION:
*Altus Vision Benefit Summary
*VSP Network

*TruHearing Hearing Aid Discount Offer (Member)

*VSP Diabetic Eyecare Plus Program
*Altus Vision Enrollment Form