Non-Medicare Eligible Retiree Health Plans

Blue Cross Blue Shield (BCBS) - www.home.bluecrossma.com

Network coverage area includes MA, RI, CT, NH, ME & VT

BCBS Benchmark Plan (HRA eligible) Group Number 00-4053588	BCBS High Deductible Health Plan (HSA eligible) Group Number 00-4062729
BCBS Benchmark Enrollment Form	BCBS HDHP Enrollment Form
BCBS Benchmark Summary of Benefits and Coverage	BCBS High Deductible Summary of Benefits and Coverage
BCBS Benchmark Plan Summary	BCBS High Deductible Plan Summary
	BCBS Preventative Drug List - medications at co-pay level (deductible does not apply)
	$9 Generic Drug List
Blue Cross Prescription Formulary	Blue Cross Prescription Formulary
Good Health Gateway Diabetes Program	Good Health Gateway Diabetes Program
CanRx Program	CanRx Program
Find a Doctor* Tool Requires Dr. name, zip code and network Plan Name = Network Blue New England Deductible HMO Network = Network Blue New England with Hospital Choice Cost Share Feature Customer Service #: 800-262-2583	Find a Doctor* Tool requires Dr. name, zip code and network Plan Name = Access Blue New England Saver Network = HMO Blue New England Customer Service #: 800-262-2583

*When searching the BCBS website for a doctor, be sure to use all the credentials listed above for the specific plan you are interested in.  If your doctor does not appear in the online search tool, please call the customer service number listed above, give the group number of the BCBS option you are interested in and ask the representative to assist you in your doctor search. 

Blue Cross Blue Shield Limited Network Plans (BCBS) - www.home.bluecrossma.com

Network coverage area includes MA ONLY**

BCBS Benchmark Select Plan (HRA eligible) Group Number 00-4069885	BCBS High Deductible Health Select Plan (HSA eligible) Group Number 00-4070369
BCBS Select Benchmark Enrollment Form	BCBS HDHP Select Enrollment Form
BCBS Benchmark Select Summary of Benefits and Coverage	BCBS High Deductible Select Summary of Benefits and Coverage
BCBS Benchmark Select Plan Summary	BCBS High Deductible Select Plan Summary
Find a Doctor* Tool Requires Dr. name, zip code and network Plan Name = Network Blue New England Deductible HMO Network = HMO Blue Select Customer Service #: 800-262-2583	Find a Doctor* Tool requires Dr. name, zip code and network Plan Name = Access Blue New England Saver Network = HMO Blue Select Customer Service #: 800-262-2583
*ALL other plan materials for this plan are the same as noted in the BCBS chart above

*When searching the BCBS website for a doctor, be sure to use all the credentials listed above for the specific plan you are interested in.  If your doctor does not appear in the online search tool, please call the customer service number listed above, give the group number of the BCBS option you are interested in and ask the representative to assist you in your doctor search.

Harvard Pilgrim Health Care (HPHC HMO) - www.harvardpilgrim.org

Network coverage area includes MA, RI, CT, NH, ME & VT

HPHC Benchmark Plan (HRA eligible) Group Number 028848-0030	HPHC High Deductible Health Plan (HSA eligible) Group Number 018992-0018
HPHC Benchmark Enrollment Form	HPHC HDHP Enrollment Form
HPHC Benchmark Plan Summary	HPHC High Deductible Plan Summary
CanRx Program	CanRx Program
Good Health Gateway Diabetes Program	HPHC Preventative Drug List - medications at co-pay level (deductible does not apply)
HPHC Hospital Tier Listing	Good Health Gateway Diabetes Program
Find a Doctor Plan Type = HMO Plan Category = Tiered/Limited Plans Tiered/Limited Plans = ChoiceNet HMO-2022	Find a Doctor Plan Type = HMO Plan Category = Standard Plans Standard Plans = HMO or HMO Open Access

Tufts Health Plan - www.tuftshealthplan.com

Network coverage area includes MA, RI, NH, and extended service areas in Southern ME, Eastern VT and just over the CT border

Tufts Benchmark Plan (HRA eligible) Group Number 45843-130	Tufts High Deductible Health Plan (HSA eligible) Group Number 57527-130
Tufts Benchmark Enrollment Form	Tufts HDHP Enrollment Form
Tufts Benchmark Plan Summary	Tufts HDHP Plan Summary
CanRx Program	Tufts Health Plan Preventative Drug List - medications at co-pay level (deductible does not apply)
Tufts Prescription Formulary	Tufts Prescription Formulary
Good Health Gateway Diabetes Program	Good Health Gateway Diabetes Program
	CanRx Program
Find a Doctor - Tufts Benchmark Plan	Find a Doctor - Tufts HDHP

Harvard Pilgrim PPO (HPHC PPO) - www.harvardpilgrim.org