MEDICAL
Insured Preferred Provider Plans
Product NameForm Number
Aetna Life Insurance CompanyOpen ChoiceGR-9
Aetna Life Insurance CompanyManaged ChoiceGR-9
Aetna Life Insurance CompanyStudent Blanket PolicyGR96134
Aetna Life Insurance Company 1Student Sports Accident InsuranceGR-96449 1005 ED. 01-10 et al.
Aetna Life Insurance Company 2Savings PlusGR-9 et al.
Blue Cross and Blue Shield of Massachusetts, Inc.Blue Care ElectBCBS-PPO (1-1-2013)
Combined Insurance Company of AmericaBlanket Student Accident & SicknessUH P63003 0604 MA
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.
CIGNA Health and Life Insurance CompanyMedical LocalPlusHC-CER1, et al.
4 Ever Life Insurance CompanyGlobal Health Guard54.1301 MA
Fallon Health & Life Assurance CompanyFallon Preferred Care15-670-031
Fallon Health & Life Assurance CompanyFallon Preferred Care15-670-031
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
HPHC Insurance Company, Inc.Hospital PreferSM Best Buy PPO1456 (Grp)/1459 (Ind) & SOB1455
Minuteman Health, Inc.3MyDoc PPO NationalMHI-NatlPPO-EOC CLEAN-8112015
National Guardian Life Insurance CompanyConsolidated Health Plans, Inc.NBHCert-280(2014) PPO MA w/First Health
National Guardian Life Insurance CompanyConsolidated Health Plans, Inc.NBHCert-280(2014) PPO MA w/Multiplan, Inc.
National Guardian Life Insurance CompanyConsolidated Health Plans, Inc.NBHCert-280(2014) PPO MA w/Cigna 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 Company
 
Advantage PPOMA-TICOPPO-001 Ed.1-2012
Tufts Insurance Company
 
CareLink
 
MA-TICOPPO-002 Ed. 1-2012
 
Tufts Insurance CompanyStudent Health PPOMA-TICOPPO-003
Tufts Insurance CompanySports Accident PPOMA-TICPPO-SPACC-001 Ed. 1-2015
United HealthCare Insurance Company Choice PlusCOC17.CER.I.11.LG.MA & SBN17.CHP.I.11.LG.MA
United HealthCare Insurance CompanyOptions PPO COC17.CER.I.11.LG.MA & SBN17.OPT.I.11.LG.MA
United HealthCare Insurance CompanyTransplant Benefit CertificateUCC-CERT-MA (02/04)
United HealthCare Insurance CompanyOptions PPO Non-DifferentialCOC17.CER.I.11.LG.MA & SBN17.NDF.I.11.LG.MA
United HealthCare Insurance CompanyBlanket Student PPO Injury & Sickness Benefits Group PolicyCOL-17-MA CERT



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.
2 The "Savings Plus" Network tiers acute care hospitals & specialists.
3 Plan in-network coverage includes (1) providers who contract directly with MHI and (2) providers in the First Health Network when services are received OUTSIDE of the 7 counties in MHI’s Service Area.

*  Unicare Life and Health Insurance Company (Form #s BCR 100.1 MA 10/04 and BCR 105.1-MA 11/04). does not appear above due to their decision to discontinue the offer of the plan(s) in Massachusetts.