HCN News & Notes

Harvard Pilgrim Provides Broad COVID-19 Relief with $32 Million in Premium Credits

WELLESLEY — Harvard Pilgrim Health Care announced it will provide $32 million in premium credits to all its fully insured employer groups, as well as to Medicare Supplement members. Additionally, the nonprofit health plan announced it will provide $3 million in financial support to independent primary-care physicians and $3 million to support community health centers, and the insurer will waive all primary-care and specialty-care co-pays for office visits for Medicare Advantage members through the end of the year. 

“Harvard Pilgrim’s commitment to our members, customers, communities, and provider partners has never been stronger,” said Michael Carson, president and CEO of Harvard Pilgrim Health Care. “The actions we are announcing today are a continuation of our broad-based COVID-19 support. Our first phase of relief included over $40 million in payment advances to provider organizations across New England, nearly $4 million in community-support grants, and a number of member-focused cost-share waivers for COVID-19 testing, treatment, and the advancement of telehealth services. Today’s actions are focused on providing financial relief to our employer groups and members, as well as to further contribute to solutions aimed at addressing the complex health challenges the pandemic has brought to black and brown communities already experiencing significant health disparities and access to care issues.”

Carson added that “the pandemic, and the resulting need for stay-at-home orders and social distancing, has caused deferrals in elective procedures and non-emergent and routine care, which has resulted in temporarily lowered volume of healthcare claims. While there is a tremendous amount of uncertainty surrounding healthcare spending and the impact of deferred care for the remainder of the year, we believe that it is appropriate to provide this material premium relief to our employer groups at this time. We will continue to closely monitor healthcare claim trends and determine how to best support our customers, communities, and care-delivery system partners going forward.”

Harvard Pilgrim will be providing the following relief and support to members, customers, independent primary-care physicians, and community health centers:

• Fully-insured employer groups, regardless of size or location, will receive a 15% credit on their September premium invoice ($30 million total);

• Medicare Supplement members will receive a 15% credit on their September invoice ($2 million total);

• Medicare Advantage members co-pays for all primary-care and specialty-care office visits will be waived starting July 1 until the end of 2020;

• Independent primary-care practices will have access to $3 million in financial support to assist with aspects of reopening their practices. To support the provider community, Harvard Pilgrim provided more than $40 million in financial advances to providers throughout the region;

• Community health centers, particularly those providing care to predominately black and brown communities, as well as centers that provide care for vulnerable populations, will receive $3 million to support equity and equality in accessing healthcare and address health disparities; and

• COVID-19 testing and treatment cost-share waiving and no out-of-pocket expense for telehealth services will continue through Sept. 30. Harvard Pilgrim will reassess these policies as circumstances warrant.

Harvard Pilgrim is awaiting regulatory approval for this action in Connecticut, which it expects to receive shortly. Additionally, the insurer is awaiting regulatory guidance for the potential of issuing relief for 2020 individual health plans. The health plan will continue to evaluate claim trends and may implement additional actions to provide premium relief, as well as additional support initiatives, throughout the remainder of the year. 

Since the start of the pandemic, the Harvard Pilgrim Health Care Foundation has donated close to $4 million to nonprofit organizations throughout the region to help provide food, transportation assistance, and other support services to older adults and low-income families impacted by the pandemic.