Granite Premier Choice
Innovation that results in cost savings for you and your employees
With our Granite Premier Choice PPO and EPO tiered plans, members are incentivized by differential copays, deductibles and coinsurance to select high-value providers that offer quality care at a lower cost.
Granite Premiere Choice EPO
Offering many plan options including two tiers of coverage, employees must select a PCP to coordinate their care with network providers and specialists. Referrals are required for most nonemergency services.
Granite Premiere Choice PPO
Offering numerous plan options with two tiers of in-network coverage plus out-of-network coverage, no referrals are needed when employees visit specialists.
We recognize that employers in New Hampshire may need coverage options outside of the Tufts Health Freedom Plan regional service area. For those employers, we offer plans with access to a nationwide network.
When it comes to drug coverage, our pharmacy management programs help contain costs while managing quality. Our 4-tier pharmacy program helps manage high-cost specialty drugs and provides the ability to cap member cost share exposure. 3-tier plans are also available for large groups.
From fully insured to self-funded—our full spectrum of member and client management services and our menu of integrated health, wellness and care management packages are available for all funding options.
Self-Funding: Our self-funding options provide employers with 100 or more enrolled subscribers opOur self-funding options provide employers with 100 or more enrolled subscribers opportunity to achieve sustainable cost control and significant savings, while insulating employers from the ACA health insurer fee impact through
simplified TPA-like fees.
Level Monthly Funding: Transitioning to self-funding could be a huge step so we created a mechanism to provide predictable cash flows with the opportunity to earn a year-end credit if annual claims are lower than projected. It’s a great transition tool for employers with 51 or more enrolled subscribers that are considering the advantages of self-funded plans but need the month-to-month predictability.
Granite Premiere Choice opens up possibilities for you to provide cost-effective options for your employees with two levels of in-network care. Employees pay different levels of copayments, coinsurance and/or deductibles for covered services delivered by Tier 1 and Tier 2 providers.
Tier 1 provides cost savings (in the form of lower deductibles and copays) when employees choose care that’s delivered within Tier 1. Our robust Tier 1 network leverages the Granite Health Network as well as seven additional health systems across New Hampshire and in Massachusetts, including Dartmouth-Hitchcock, Massachusetts General Hospital and Brigham and Women’s Hospital, totaling more than 1,100 PCPs and over 5,300 Specialists. The cost-sharing structure encourages employees to choose Tier 1 providers while still offering the choice of Tier 2 providers.
Tier 1 Additional Services
Behavioral Health and Substance Abuse: For all behavioral health and substance abuse services and treatments, employees can access any in-network facility at the Tier 1 level.
Emergency Care: Emergency services are covered at the Tier 1 level. PCP approval is not required before receiving emergency care.
Tier 2 gives your employees access to the remaining Tufts Health Plan network of 84 hospitals and 25,000+ PCPs and specialists in New Hampshire, Massachusetts and Rhode Island.
Granite Premier Choice offers high-value benefits with more access. It’s a powerful combination for controlling costs and empowering employees to take charge of their own health care spending through top-quality providers.