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  • About Your Coverage

    If your child is enrolled in Healthy Kids Silver or Healthy Kids Buy-In, here are some documents that will be helpful to you.

    Documents:

    Welcome Letter
    This letter will give you an overview of your child’s coverage and introduce you to the Healthy Kids programs. It has helpful contact information and payment information as well.

    Harvard Pilgrim Health Care
    www.harvardpilgrim.org/healthykids

    Questions & Answers Sheet about Harvard Pilgrim Health Care

    Member Handbook & Primary Care Provider Directory

    The following documents are effective until June 30, 2010.  Enrolled families should continue to refer to these until that time:

    Healthy Kids Silver Member Coverage Certificate

    Healthy Kids Silver Summary of Benefits

    Healthy Kids Buy-In Member Coverage Certificate

    Healthy Kids Buy-In Summary of Benefits

    The following documents will replace those listed above effective July 1, 2010.  Enrolled families should begin using these documents at that time:

    Healthy Kids Silver Member Coverage Certificate - July 1, 2010

    Healthy Kids Silver Summary of Benefits - July 1, 2010

    Healthy Kids Buy-In Member Coverage Certificate - July 1, 2010

    Healthy Kids Buy-In Summary of Benefits - July 1, 2010

    Northeast Delta Dental
    www.nedelta.com

    Summary of Healthy Kids Silver & Buy-In Dental Benefits

    Healthy Kids Silver & Buy-In Dental Plan Description


    Renewal Forms:

    Renewal Application
    Use this application for the yearly renewal of your child’s health coverage

    Renewal Application - Spanish Version
    Use this application for the yearly renewal of your child’s health coverage


    Accounting Forms:

    Healthy Kids Silver Automatic Premium Withdrawal
    Use this form to authorize NHHK to automatically withdraw your premium payments from your bank account.

    Healthy Kids Buy-In Automatic Premium Withdrawal
    Use this form to authorize NHHK to automatically withdraw your premium payments from your bank account.


    Reporting Changes:

    Instructions for Reporting Income & Address Changes  

     

     

     

    New Hampshire Healthy Kids Ÿ 1 Pillsbury Street, Suite 300 Ÿ Concord, NH 03301-3556
    1-877-464-2447 
    Ÿ 603-228-2925
    Fax: 603-228-8940


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