Harvard Pilgrim Health Care Case Study – Partners for more than 25 years

About Harvard Pilgrim Health Care

Harvard Pilgrim Health Care is a full-service health benefits company serving self-insured, small and large group employers, and all market segments throughout Massachusetts, New Hampshire, Maine and beyond. They have been recognized as one of America’s best health plans for 10 years in a row by the National Committee for Quality Assurance.


Harvard Pilgrim Health Care was continuously growing, and with this growth came scalability issues. In 1994, Harvard Pilgrim Health Care’s leadership team sought out an external solution to implement multiple technology capabilities that would create a more seamless business process.

Solution - Why Harvard Pilgrim Health Care Chose Mosaic

'When evaluating partners to act as an extension of your team, we at Harvard Pilgrim place emphasis on selecting organizations that have expertise and focus, backed by reputation within the industry --  Mosaic Insurance Exchange hits on all the marks. We value their partnership in delivering and meeting the expectations of small business team(s) and in being a reliable partner to support Harvard Pilgrim Health Care’s scalability.” 

Outsourcing to Mosaic Insurance Exchange made great business sense to Harvard Pilgrim Health Care because of the years of experience, focused approach, reputation within the industry, ability to deliver and meet expectations, and ability to support Harvard Pilgrim Health Care’s needs.

Key services Mosaic Insurance Exchange provides Harvard Pilgrim Health Care are:

  • E-billing and Collections – According to Harvard Pilgrim Health Care representatives, one of the most beneficial services Mosaic Insurance Exchange provides is premium billing and collections. Handling broker compensation requires a lot of additional work and would require Harvard Pilgrim Health Care to add many internal resources. Instead, Mosaic Insurance Exchange handles billing and collections directly.
  • Account Management – Mosaic Insurance Exchange offers great communication skills amongst the various accounts and provides the education, strategy and resources the businesses need to stay up to date on the latest changes and technology within the industry.
  • EDI Submission – The EDI files are simple and load directly and efficiently into Harvard Pilgrim Health Care system, allowing for increased accuracy of forms. 
  • Call Center Support – Mosaic Insurance Exchange’s call center support matches the level of customer service that Harvard Pilgrim Health Care strives to offer. Customer satisfaction has improved due to Mosaic Insurance Exchange’s concrete call center training, knowledge and industry experts.

'We understand and appreciate that small employers want to focus on achieving their business objectives – not managing compliance-related issues when it comes to employee benefits. Mosaic Insurance Exchange can be counted on to be a reliable, service-oriented extension of Harvard Pilgrim’s small business team, and we can count on them as a partner to mirror the same level of responsiveness and commitment that we are dedicated to providing to all of our employer groups.'

Mosaic Insurance Exchange is currently administering a non-group shopping and enrollment site in partnership with Harvard Pilgrim, the site can be found here: http://harvardpilgrim.mosaicix.com/.

Tufts Health Plan Case Study    

Mass Health Connector Case Study