About Your Health Benefits
Think healthy, live well. There is nothing more valuable than good health. UNE offers a choice of medical insurance plans that are designed to help you and your family stay healthy and provide comprehensive coverage when you need it.
Summary of Benefits and Coverage (SBC) and Summary of Plan Description (SPD) for all benefits-eligible employees are located on our Human Resources benefit web pages for each coverage type. These documents provide standard coverage information for the three medical plans through Harvard Pilgrim. The SBC is also available in paper form free of charge upon request. If you want a printed copy or have any coverage questions, please reach out to Human Resources and we will be happy to help.
Once enrolled in benefits, we recommend that you regularly review your contact information (mailing address, email, and phone number) with elected insurance carriers to make sure it is up-to-date.
Health Plan Presentations, Flyers, and Forms
The Domestic Partner Affidavit (PDF) certifies the necessary requirements for unmarried domestic partners’ eligibility to be included in health and dental insurance coverage
- Understanding your 2023 Health Plan Health Plan options (video)
- Alternatives to going to the Emergency Room (PDF)
- Learn the Benefits of creating a My Member account (PDF) with Harvard Pilgrim.
- The Discounts and Savings flyer (PDF) helps you and your family find savings on your way to well being.
- Doctors on Demand: Virtual health care visits (PDF)
- The Harvard Pilgrim Care Team flyer (PDF) introduces a team that can help address your health care concerns and alleviate worries.
- Harvard Pilgrim's Digital insurance card made easy (PDF) flyer helps you locate your insurance information when you don't have your card with you.
- Our Journey to Parenthood (PDF) flyer introduces three mobile apps with useful information as you embark on this journey of a lifetime called parenthood.
- Preventative screenings that are good for your health (PDF)
- What you need to know about preventative care under the ACA (PDF)
- Your HDHP/HSA enrollment kit (PDF)
- What your HDHP/HSA plan covers and how is it paid (PDF)
- Receiving care outside of New England with a HDHP/HSA Plan (PDF)
- Harvard Pilgrim: 5 facts about the POS HSA plan (PDF)
- Harvard Pilgrim: Your HSA POS plan and how it works in Maine (PDF)
- Harvard Pilgrim: Electing or changing your PCP (PDF)
- Benefit Wallet: HSA Overview (video)
- Benefit Wallet: Saving with your HSA (video)
- Benefit Wallet: Spending with your HSA (video)
- Benefit Wallet: Investing with your HSA (video)
- Social Security and Medicare Presentation (PDF)
- Individuals approaching retirement age have unique considerations regarding their income and benefits. View this presentation to learn about your options in the months and years leading up to retirement.
Eligibility
- Full- or half-time faculty or professional staff (self)
- Spouse or Domestic Partner
- Dependent Children (and those of a Domestic Partner) until the end of the month they turn 26 years of age
- Participation in health coverage may begin the first of the month after your hire or qualifying event. If your hire or event occurs on the first of the month, then benefits begin on the date of hire or qualifying event.
- Coverage ends the last day of the month in which you physically work in a benefits-eligible position.
- When and under what circumstances can a mid-year change be made to my benefits? (PDF)
- Please review the Summary Plan Descriptions for more eligibility details and consult with Human Resources for specific situations.
Benefits and Coverage Questions
Harvard Pilgrim Member Services
- (888) 333-4742
- Monday, Tuesday, and Thursday 8 a.m.–6 p.m.
- Wednesday 10 a.m.–6 p.m.
- Friday 8 a.m.–5:30 p.m.
Health Plan Support and Clinical Coordination
Harvard Pilgrim Care Management
- (866) 750-2068
- Monday–Friday 8:30 a.m.–5 p.m.
Health Plan Options
Reviewing the Benefits Guide (PDF) and other resources provides you with the needed information to elect the best health care option for you and your family and even answer many of the questions that arise over time.
Health Basic
This in-network plan provides a moderate co-payment option and has mid-level monthly premium costs. Learn more about your Basic Health plan
Health Enhanced
This in-network plan provides lower co-payments and has the highest monthly premiums. Learn more about your Enhanced Health plan
High Deductible Health Plan with Health Savings Account (HSA)
This plan offers in and out of network benefits at a low monthly premium. In 2022, UNE will be providing up to $2,600 (dividing it up among each pay period) to eligible participants' HSA, and participants have the option to contribute additional money (within limitations set by the IRS). Learn more about the High Deductible Health Plan and the HSA option
Vision Benefits
Vision benefits are detailed on our web page and are included as part of your health care plan.
Pharmacy Benefits
Reviewing Your Guide to Prescription Coverage (PDF) will help you to make the most effective decisions regarding your pharmacy benefits. Other resources include the Guide to Over-the-Counter Medications (PDF) and the Guide to Preventative Drug Benefits for HSA plans (PDF).
Behavioral Health
Behavioral Heath support is more important than ever. You have behavioral health resources as part of your health insurance coverage. Additionally, you can:
- Get on-demand help with stress, depression, and anxiety anytime with the Sanvello App (PDF).
- Connect with a therapist through Talkspace (PDF) – a safe and secure digital therapy service.
Overseas Urgent and Emergency Care
With UNE's presence in Morocco and the increased global connections across the University, this information will be of assistance to anyone covered under the health plans who is traveling overseas.
Health Plan Support and Clinical Education
- Access My Health Math to choose the right Harvard Pilgrim plan for you.
- My Health Math Decision Doc (PDF): Is it time to change your Health Plan? Certain things are considered qualifying life events that make you eligible to enroll in a plan though your employer. Decision Doc can help you choose the plan that matches your specific health needs. Visit www.myhealthmath.com/une2023 or email questions to questions@myhealthmath.com.
Special Notices
Medicare Part D – Notice of Creditable Coverage
The prescription drug coverage listed under the University of New England's medical plan is expected to payout, on average, at least as much as the standard Medicare prescription drug coverage will pay in a calendar year and is considered "creditable coverage." If you or your covered dependents are enrolled in any prescription drug coverage listed in this notice of creditable coverage (PDF) and are or become covered by Medicare, you may decide to enroll in a Medicare prescription drug plan later and not be subject to the late enrollment penalty as long as you had creditable coverage within 63 days of your Medicare prescription drug plan enrollment. Please read the notice of creditable coverage (PDF) carefully and keep this notice with your important records.
Additionally, Health Advocate is a free and confidential resource to help you, your spouse, dependent children, parents, and parents-in-law answer questions regarding Medicare.
- Learn about the ABC's of Medicare (PDF)
- Top reasons to call for Medicare guidance (PDF)
- Top reasons to call for Medicare guidance (French) (PDF)
Retiree Medical Insurance Coverage
UNE offers a program for long-term employees to continue on the university medical plan under certain circumstances prior to age 65. The cost for continuing medical coverage for early retirees will be borne completely by the former employee. The purpose of this extension of benefits is to allow access to group coverage prior to their eligibility for Medicare for employees wishing to retire early.
The following criteria must be met in order to qualify:
- The employee must have completed 20 years of service at the time that the continuation of coverage becomes effective
- The employee must be age 60 prior to their retirement date
Coverage continues until the date the retiree and eligible dependent become entitled to Medicare
Please contact Human Resources for more information.
Resources
Online Health Resources
We continue to find ways to bring you health care in ways that are convenient. Create an online account and get the mobile apps to get access to your health and dental information, ID card, and other resources on your mobile device.
- Set up your Harvard Pilgrim Online Account (PDF)
- Access your Harvard Pilgrim Digital ID Card (PDF)
- Set up your Delta Dental Mobile App (PDF)
- Access MyHealthMath to choose the right Harvard Pilgrim plan for you.
- Harvard Pilgrim Reduce My Cost program (PDF)
- Use this feature to find ways to reduce health care costs for outpatient procedures and diagnostic tests. You may receive cash rewards for choosing to save money.
- Using Your Harvard Pilgrim Account (English Video)
Find a Doctor
- Harvard Pilgrim provider search
- Find an in-network provider from your Harvard Pilgrim Account (PDF)
- Find a in-network HDHP-HSA plan provider without logging in to your account (PDF)
- Find an in-network Basic or Enhanced plan provider without logging to your account (PDF)
- Find an in-network provider (video)
- Choose or change your primary care physician (PDF)
It is helpful to remember:
- Insurance bills under doctors, not facilities, so it is best to search for a doctor's name.
- Nurse Practitioners bill under the doctor's name, so it is best to search by the doctor's name.
- Hospitals are searchable to confirm that they are in-network.
Reduce My Costs
Pay less in out-of-pocket expenses for procedures and tests and get cash rewards. Harvard Pilgrim can help you save money with their voluntary Reduce My Costs program.
Learn more about the Reduce My Costs program (PDF)
Health Advocate
Heath Advocate is a free and confidential benefit that helps you and your family (spouse, dependent children, parents, and parents-in-law) get answers involving your medical, hospital, dental, mental health, medications, and other health care and selected life event issues. The Health Advocate Overview (PDF) outlines the many features provided. Other resources include:
- The Top Reasons to Call Heath Advocate - English (PDF)
- The Top Reasons to Call Heath Advocate - French (PDF)
- Health Advocate's Clinical Advisory Service (PDF) can assist when dealing with a serious health issue. The Clinical Advisory Service document is also available in French (PDF).
- Tips on Protecting Against Identity Theft (PDF)
- Set up your Health Advocate Mobile Account (PDF)
Contact Health Advocate by calling 1 (866) 695-8622. Normal business hours are Monday–Friday, between 8 a.m. and 9 p.m. EST, but staff is available after hours and on weekends.