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