Medical – EPO/PPO
 

Introduction

Please refer to Definitions for the words and terms used in this section. 

Tufts Associated Health Plan, Inc. (also referred to as the “Company” or “Tufts Health Plan”), provides the following medical benefit plan options for employees. For information on which plans you are eligible for, refer to Eligibility and Plan Participation for more information.

  • Your Choice Exclusive Provider Option (EPO)
  • Your Choice Preferred Provider Option (PPO)
  • Cigna Out-of-Area PPO
  • LifeSpan Premier Choice EPO (Rhode Island residents only)
  • Granite Premier Choice EPO (New Hampshire residents only)
The Your Choice Exclusive Provider Option (EPO) and Your Choice Preferred Provider Option (PPO) medical plans meet Massachusetts Minimum Creditable Coverage standards and will satisfy the Massachusetts individual mandate to have health insurance. Please see the cover page of your EPO or PPO Description of Benefits booklet for additional information.

DESCRIPTION OF BENEFITS BOOKLETS

Your Choice Exclusive Provider Option (EPO) Description of Benefits
Your Choice Preferred Provider Option (PPO) Description of Benefits
Cigna Out-of-Area PPO Description of Benefits
LifeSpan Premier Choice EPO Description of Benefits
Granite Premier Choice EPO Description of Benefits 

WHO INSURES YOUR BENEFITS?
Your medical plan benefits are self-insured by Tufts Associated Health Plan, Inc.

Claim Administrator
The claim administrator is the entity authorized by each Plan to interpret the Plan, and approve or deny claims and appeals. As used in this section, the term “claim administrator” for each Planrefers to:

  • Total Health Plan, Inc., for the Exclusive Provider Option (EPO)
  • Tufts Benefit Administrators, Inc. for the Preferred Provider Option (PPO)
  • Tufts Health Plan, Inc., for the LifeSpan Premier Choice EPO
  • Tufts Health Freedom Plan for the Granite Premier Choice EPO

Address:
705 Mount Auburn Street
Watertown, MA 02472-1508

QUESTIONS?
If you have any questions, call a Member Specialist Monday through Friday from 8:00 am to 7:00 pm, and Friday from 8:00 am to 5:00 pm. 

Your Choice EPO                                                                            1-877-658-3635 

Your Choice PPO                                                                            1-877-658-3635

Cigna Out-of-Area PPO                                                                  1-800-682-8059 

LifeSpan Premier Choice EPO                                                       1-800-682-8059

Granite Premier Choice EPO                                                         1-888-501-6048     

Telecommunications Device for the Deaf (TDD) for Massachusetts and Rhode Island: If you have access to a TDD phone, call 1-800-868-5850 to reach the Tufts Health Plan Member Services Department. 

Massachusetts Relay (Mass Relay): 1-800-720-3480
Rhode Island Relay: 1-800-745-5555

Telecommunications Device for the Deaf (TDD) for New Hampshire: If you have access to a TDD phone, call 711 to reach the Tufts Health Plan Member Services Department. 

Relay New Hampshire: 1-800-735-2964 

This website summarizes the official Plan documents for your medical plans. The full facts and details concerning the operation of these plans are contained in official Plan documents, which are on file with Human Resources. In the event of any conflict between this section and the official Plan documents, the Plan documents will always govern. The official Plan documents will also govern over any conflicting oral representations concerning the benefits provided under these plans.