Integrated Statistics Health Plans 2020-21

Integrated Statistics offers two Harvard Pilgrim Plans.

The HMO plan is for residents of CT, MA, ME, and RI.

The PPO plan is for residents of other states, or for anyone who prefers a PPO.

You will find descriptions of both plans below. You may choose either plan.

Information that applies to both plans

Notices

• Federal Notice: Marketplace Coverage Options
• Premium Assistance Under Medicaid and the Children’s Health Insurance Program (CHIP): Potential help with paying health insurance premiums for children.

Get the Most Out of the Plan

• Receiving Care Outside of New England: Info for participating UnitedHealthcare providers outside of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.
• Reduce the Cost of Services: Pay less in out-of-pocket expenses for procedures and tests.
• Well-being Program: Earn rewards and reimbursements.
• The HPHC website has additional discounts and savings, but you have to log in to see them. Here's the link.
• OptumRx Pharmacy Services Transition Frequently Asked Questions for Members.

Forms to Download

• OptumRx Home Delivery Order Form
• Waiver of Coverage form: complete this form if you don't need coverage from Integrated Statistics.
• Section 125 Premium Only Plan Election Form Each year or when you sign up, we also need new Schedule As from everyone to comply with the Section 125 cafeteria plan regulations set forth by the IRS. Please send in this form when you are signing up.
• The HPHC sign-up form

HMO plan

• Summary of Benefits and Coverage for HMO
• Detailed Schedule of Benefits for HMO

PPO Plan

• Summary of Benefits and Coverage for PPO
• Detailed Schedule of Benefits and Coverage for PPO