MEDICAL
Insured Preferred Provider Plans
Product NameForm Number
ACE Property and Casualty Insurance CompanyStudent Accident & Sickness PolicyAH-29564-MA
Aetna Life Insurance Company 1Student Sports Accident InsuranceGR-96449 1005 ED. 01-10 et al.
AXIS Insurance CompanyStudent Blanket PolicyBSAS-002-0211-MA
Blue Cross and Blue Shield of Massachusetts, Inc.Blue Care ElectBLUE CARE ELECT (01-01-06 Rev.)
CIGNA Health and Life Insurance CompanyPoint of ServiceHC-CER1, et al.
CIGNA Health and Life Insurance CompanyPoint of Service Open AccessHC-CER1, et al.
CIGNA Health and Life Insurance CompanyCareLink/Open Access PlusHC-CER1, et al.
CIGNA Health and Life Insurance CompanyPPOHC-CER1, et al.
CIGNA Health and Life Insurance CompanyOpen Access PlusHC-CER1, et al.
Connecticut General Life Insurance CompanyPoint of ServiceGM6000 C2, et al.
Connecticut General Life Insurance CompanyPoint of Service Open Access
 
GM6000 C2, et al.
 
Connecticut General Life Insurance CompanyPPOGM6000 SC19 et al.
Connecticut General Life Insurance CompanyCare Link/Open Access PPO
 
GM6000 SC19, et al.
 
Connecticut General Life Insurance CompanyOpen Access PlusGM6000, et al.
4 Ever Life Insurance CompanyGlobal Health Guard54.1301 MA
Fallon Health & Life Assurance CompanyFallon Preferred Care11-670-345 Rev. 00 12/11
Fallon Health & Life Assurance CompanyFallon Preferred Care11-670-345 Rev. 00 12/11
Harvard Pilgrim Health Care, Inc.Premium PPO 10MAPPO0701
Harvard Pilgrim Health Care, Inc.Value PPO 15 $250 admissionMAPPO0701
Harvard Pilgrim Health Care, Inc.Best Buy PPO 500; 1000, 2000MAPPO0701
HPHC Insurance Company, Inc.The PPO Plan MassachusettsMAG1PPOHBREV
HPHC Insurance Company, Inc.Best Buy HSA PPO310
HPHC Insurance Company, Inc.HPHC Qualifying Student Health PlanHPHC 06-BR-MA-PPO
Monumental Life Insurance CompanyStudent Acc. & Sickness Ins. ProgramNHG-MP-400.MA
Nationwide Life Insurance CompanyStudent Acc. & Sickness Ins. ProgramNW PHCS 101 10/26/04
Nationwide Life Insurance CompanyStudent Acc. & Sickness Ins. ProgramNW CERT 101 5/19/03
Nationwide Life Insurance CompanyStudent Acc. & Sickness Ins. ProgramNW CIGNA 101
Neighborhood Health Plan, Inc.NHP Prime PPONHPPPOv3
Tufts Associated Health Maintenance Organization, Inc.POS OptionCC-MAPOS-001 Ed. 1-2012
 
Tufts Associated Health Maintenance Organization, Inc.PPOMA-PPO-001 Ed. 1-2012
 
Tufts Insurance CompanyAdvantage PPOMA-TICOPPO-001  Ed.1-2012
 
Tufts Insurance CompanyCareLink
 
MA-TICOPPO-002 Ed. 1-2012
 
Tufts Insurance CompanyStudent Health PPOMA-TICOPPO-003
UniCARE Life and Health Insurance Company Unicare Classic PPOGCR100 et al.
United HealthCare Insurance CompanySelect PlusSELECTP.I.01.MA
United HealthCare Insurance Company Choice PlusCHOICEP.I.01.MA
United HealthCare Insurance CompanyOptions PPO OPTIONSPPO.I.01.MA
United HealthCare Insurance CompanyTransplant Benefit CertificateUCC-CERT-MA (02/04)
United HealthCare Insurance CompanyOptions PPO 80/80OPTIONS80/80.I.01.MA
United HealthCare Insurance CompanyQualifying Student Health Plan12-BR-MA-PPO


 

1 Form GR-96449 1005 ED. 01-10 et al to replace the originally filed form GR-96487-1 ED. 10-07 et al upon group's renewal date.

* Please note that the following companies or product(s) do not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts - Unicare Life and Health Insurance Company (Form #s BCR 100.1 MA 10/04 and BCR 105.1-MA 11/04) and United HealthCare Insurance Company (Form# CPCEMA497).