PPO HSA 2000 - Flex - 36046MA0810067 Health Insurance Plan
Harvard Pilgrim Healthcare, Inc. health insurance plan with the Plan ID 36046MA0810067. The plan is called PPO HSA 2000 - Flex.
Based on the data of Health Plan Issuer, this plan has an actuarial value of 71.77% (the percentage of total average costs for covered benefits that a plan will cover). So, on average, you would be responsible for 28.23% of the costs of all covered benefits (according to the Issuer).
| Health Insurance Plan ID | 36046MA0810067 | ||||||||||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Health Insurance Plan Year | 2024 | ||||||||||||||||||
| State | Massachusetts | ||||||||||||||||||
| Health Insurance Issuer | Harvard Pilgrim Healthcare, Inc. | ||||||||||||||||||
| Health Insurance Plan Variant | 36046MA0810067-01 | ||||||||||||||||||
| Provider Network(s) | ['MAN003'] | ||||||||||||||||||
| In Network Doctors
*The data available in our database based on Health Insurance Company Open Data (update: Thu, 21 Nov 2024 00:44 GMT). |
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| Available Variants of the Health Plan | |||||||||||||||||||
| Last Plan Update Date | Mon, 12 Feb 2024 00:00 GMT | ||||||||||||||||||
| Last Import Date | Thu, 21 Nov 2024 00:44 GMT |
PPO HSA 2000 - Flex Health Insurance Plan Variant 36046MA0810067-01 Attributes
| Plan Attribute | Value |
|---|---|
| Business Year | 2024 |
| Child-Only Offering | Allows Adult and Child-Only |
| Composite Rating Offered | No |
| CSR Variation Type | Standard Silver On Exchange Plan |
| Dental Only Plan | No |
| Disease Management Programs Offered | Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma |
| First Tier Utilization | 100% |
| Formulary ID | MAF004 |
| HIOS Product ID | 36046MA081 |
| HSA/HRA Employer Contribution | No |
| Import Date | 2/12/2024 |
| HSA Eligible | Yes |
| IsItANewPlan | New |
| Notice Required for Pregnancy | No |
| Is a Referral Required for Specialist? | No |
| Issuer Actuarial Value | 71.77% |
| Issuer ID | 36046 |
| Market Coverage | SHOP (Small Group) |
| Medical Drug Deductibles Integrated | Yes |
| Medical Drug Maximum Out of Pocket Integrated | Yes |
| Metal Level | Silver |
| Multiple In Network Tiers | No |
| National Network | Yes |
| Network ID | MAN003 |
| Out of Country Coverage | Yes |
| Out of Country Coverage Description | All Covered Benefits except for Emergency Care are covered at the Out of Network Cost Sharing. |
| Out of Service Area Coverage | Yes |
| Out of Service Area Coverage Description | All Covered Benefits except for Emergency Care are covered at the Out of Network Cost Sharing. |
| Plan Effective Date | 1/1/2024 |
| Plan Expiration Date | 12/31/2024 |
| Plan ID (Standard Component ID with Variant) | 36046MA0810067-01 |
| Plan Marketing Name | PPO HSA 2000 - Flex |
| Plan Type | PPO |
| Plan Variant Marketing Name | PPO HSA 2000 - Flex |
| QHP/Non QHP | Both |
| SBC Scenario, Having a Baby, Coinsurance | $0 |
| SBC Scenario, Having a Baby, Copayment | $1,200 |
| SBC Scenario, Having a Baby, Deductible | $2,000 |
| SBC Scenario, Having a Baby, Limit | $0 |
| SBC Scenario, Having Diabetes, Coinsurance | $0 |
| SBC Scenario, Having Diabetes, Copayment | $700 |
| SBC Scenario, Having Diabetes, Deductible | $2,000 |
| SBC Scenario, Having Diabetes, Limit | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Coinsurance | $0 |
| SBC Scenario, Treatment of a Simple Fracture, Copayment | $400 |
| SBC Scenario, Treatment of a Simple Fracture, Deductible | $2,000 |
| SBC Scenario, Treatment of a Simple Fracture, Limit | $0 |
| Service Area ID | MAS001 |
| Source Name | SERFF |
| Plan ID | 36046MA0810067 |
| State Code | MA |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Family | per person not applicable | per group not applicable |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Combined In/Out Network, Individual | Not Applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Family | per person not applicable | per group not applicable |
| Combined Medical and Drug EHB Deductible, Combined In/Out of Network, Individual | Not Applicable |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Default Coinsurance | 0.00% |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Family | $2000 per person | $4000 per group |
| Combined Medical and Drug EHB Deductible, In Network (Tier 1), Individual | $2,000 |
| TEHBDedOutofNetFamily | $4000 per person | $8000 per group |
| Combined Medical and Drug EHB Deductible, Out of Network, Individual | $4,000 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Family | $7050 per person | $14100 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), In Network (Tier 1), Individual | $7,050 |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Family | $14100 per person | $28200 per group |
| Maximum Out of Pocket for Medical and Drug EHB Benefits (Total), Out of Network, Individual | $14,100 |
| Unique Plan Design | Yes |
| Version Number | 1 |
| Wellness Program Offered | Yes |
Copay & Coinsurance of PPO HSA 2000 - Flex Health Insurance Plan, 36046MA0810067
| Drug Tier | Pharmacy Type | Copay amount | Copay option | Coinsurance rate | Coinsurance option | Mail Order |
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Frequently Asked Questions(FAQ) about PPO HSA 2000 - Flex, 36046MA0810067 Health Insurance Plan, 36046MA0810067
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Does PPO HSA 2000 - Flex Health Insurance Plan, 36046MA0810067 support Mail Ordering?
Unfortunately, this health insurance plan does not support mail ordering or the plan data in not available.
Does (36046MA0810067) Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
Does (36046MA0810067) Health Insurance Plan, Variant (36046MA0810067-01) have Out Of Country Coverage?
Yes. Details: All Covered Benefits except for Emergency Care are covered at the Out of Network Cost Sharing.
Does (36046MA0810067) Health Insurance Plan, Variant (36046MA0810067-01) have Out of Service Area Coverage?
Yes. Details: All Covered Benefits except for Emergency Care are covered at the Out of Network Cost Sharing.
Does (36046MA0810067) Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs?
Yes, and here is the list of available programs: Pregnancy, High Blood Pressure & High Cholesterol, Weight Loss Programs, Pain Management, Depression, Low Back Pain, Diabetes, Heart Disease, Asthma
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Asthma?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Asthma.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Heart disease?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Heart disease.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Depression?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Depression.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Diabetes?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Diabetes.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for High blood pressure & high cholesterol?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for High blood pressure & high cholesterol.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Low back pain?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Low back pain.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Pregnancy?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Pregnancy.
Does PPO HSA 2000 - Flex Health Insurance Plan, Variant (36046MA0810067-01) offer Disease Management Programs for Weight loss programs?
Yes, the PPO HSA 2000 - Flex Health Insurance Plan Variant
36046MA0810067-01 offers Disease
Management Program for Weight loss programs.
Disclaimer: This is based on the import(Date: Thu, 21 Nov 2024 00:44 GMT) of the data from Healthcare Issuers listed by CMS. While we make every effort to ensure that data is accurate, you should assume all results are unvalidated. Source: CMS.gov, HealthPorta HEALTHCARE MRF API