Fully-Funded HMO and Fully-Funded PPO
On Your ID Card: Look at your ID Card. If the Group # starts with any number except "5" (see GIC) you are covered under a Fully-Funded plan. You can find the type of plan (HMO, POS, PPO, HDHP) on the right hand side of your card.
Description: Most of the plans we offer through employer groups are Fully-Funded plans. This means that the premium paid to Health New England is used to pay for medical care and pharmacy services.
Self-Funded (ASO) HMO and Self-Funded (ASO) PPO
On Your ID Card: Look at your ID Card. If the Group # starts with the letter "S" you are covered under a Self-Funded plan.Description: Some larger employer groups choose Self-Funded or ASO plans. ASO stands for "Administrative Services Only." Under these plans, the group pays a fee to Health New England. Health New England processes claims and performs other activities needed to manage the plan. The employer group pays for medical care and pharmacy services.
On Your ID Card: Look for the GIC logo on your ID Card.
Description: GIC stands for Group Insurance Commission. The GIC plan covers people who work for the Commonwealth of Massachusetts and certain municipalities (cities or towns). The GIC plan has a tiered provider network. That means that providers are assigned different copay levels (or tiers) based on access, quality and performance.
The GIC provider search can be found here: healthnewengland.org/gic-provider-search
On Your ID Card: Look for the words "Health New England Medicare Advantage" at the bottom of your ID card.
Description: Health New England’s Medicare Advantage (MA) Plans cover those who are eligible for Medicare Parts A and B. Health New England MA Plans are available to residents of Hampden, Hampshire, Franklin, and Berkshire Counties.
The Medicare Advantage provider search can be found here: healthnewengland.org/medicare/provider-lookup
On Your ID Card: Look for the Health New England BeHealthy Partnership logo on your ID card.
Description: Health New England's BeHealthy Partnership plan covers those who are eligible for coverage under the state MassHealth program. Health New England BeHealthy Partnership is available to residents of Hampden, Hampshire, Franklin, and Berkshire Counties.