MEDICAL
Insured Preferred Provider Plans
Product NameForm Number
ACE Property and Casualty Insurance CompanyStudent Accident & Sickness PolicyAH-29564-MA
Aetna Life Insurance CompanyStudent Sports Accident InsuranceGR-96487-1 ED. 10-07 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.
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
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-002 Ed. 1-2012
Tufts Insurance CompanyCareLinkMA-TICOPPO-001 Ed.1-2012
Tufts Insurance CompanyStudent Health PPOMA-TICOPPO-003
Tufts Insurance CompanySports Accident PPOMA-TICPPO-SPACC-001 Ed. 1-2015
UniCARE Life and Health Insurance Company Unicare Classic PPOGCR100 et al.
United HealthCare Insurance CompanyTransplant Benefit CertificateUCC-CERT-MA (02/04)
United HealthCare Insurance CompanyOptions PPO 80/80OPTIONS80/80.I.01.MA

*  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).

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