Harvard Pilgrim Health Care (HPHC) has sent a communication message to all impacted clients. The emails have been sent to fully insured and self-insured employer groups. The HPHC’s version includes similar updates communicated in this email, along with a letter for employers to share with their employees. The Tufts Health Plan version reinforces that there is no reason to believe Tufts Health Plan and Tufts Health Public Plan products are impacted at this time.

Enrollment: Help is available for your employees switching to HPHC

Employers that are in the process of enrolling with HPHC will be able to use HPHC’s SmartStart pre-enrollment team which is open and operational. SmartStart staff are available to answer employees’ questions about new benefits. To access this service, employees may email SmartStart@harvardpilgrim.org.

Available Resources

Urgent needs: Current members with urgent needs may call (800) 260-0574

While certain systems are unavailable, this special phone line is for members who need urgent assistance accessing care. In addition, members who call the Member Services number on the back of their ID card will hear an automated message that directs them to the number listed above.

Website updates: Check our dedicated web page for regular updates

The Point32Health website is the online hub for important information and updates related to the system outage. HPHC has committed to posting to this site regularly with new information as it becomes available. Please check this site or www.NEEBCo.com/news regularly for the most up-to-date information as HPHC transitions from sending regular emails to consistently updating this website.

Reminder: Utilization Management (UM) requirements

Last week, to ease access for HPHC members, HPHC temporarily waived UM requirements for medical and behavioral health covered services, while continuing to require prior authorizations for CAR-T cell therapy, gender-affirming surgical procedures, solid organ transplant surgeries, and all pharmacy benefit and medical benefit drugs, as the pharmacy systems continue to function normally.

Please continue to check for further updates or contact your Account Manager with questions.