Broker frequently asked questions
To better serve our Fallon Community Health Plan brokers, we've compiled some of the most frequently asked questions below.
Don't see your question listed here? Let us know and we'll work on adding it to our list!
On this page:
Question:
What's the difference between FCHP Select Care and FCHP Direct Care?
Answer:
FCHP Direct Care, a limited provider network, is a subset of the FCHP Select Care network, custom-built around some of the state’s premier physician groups and hospitals, giving you access to quality providers at a significantly lower premium cost.
FCHP Select Care offers a much broader choice of providers to help us better meet the needs of employers who have personnel throughout western, central and eastern Massachusetts. Members can choose from thousands of providers and contracted hospitals throughout the state and in southern New Hampshire.
Employers can offer both networks, as well as our PPO product, side by side. More information about the triple option.
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Question:
How do I find out the name of my assigned sales executive?
Answer:
Contact Ursula Arello, 1-508-368-9454.
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Question:
Are rates affected by broker involvement?
Answer:
Broker commissions are part of FCHP's overall administrative cost, and rates are not loaded or discounted based on the involvement of a broker.
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Question:
What are FCHP's participation guidelines?
Answer:
Fallon Community Health Plan prefers that all employees enrolled by the Employer into the plan are full-time employees working 30 hours or more per week (including any owners of the business) or part-time employees working at least 20 hours per week and receiving an employer contribution (of at least 50% of the premium) toward the health insurance coverage.
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Question:
What's the difference between Reliant Medical Group (formerly Fallon Clinic) and FCHP?
Answer:
Fallon Community Health Plan is a health maintenance organization, while Reliant Medical Group (formerly Fallon Clinic) is a physician group practice.
FCHP is a nonprofit, mixed-model HMO that provides health insurance coverage for its members through a vast network of physicians and hospitals in Massachusetts and southern New Hampshire. FCHP offers a range of health plan options to meet the needs of employers of all sizes.
Reliant Medical Group (formerly Fallon Clinic) is a multispecialty group practice.
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Question:
Does FCHP cover out-of-state employees?
Answer:
FCHP has several plans that will cover out-of-state employees. Fallon Preferred Care is a preferred provider organization (PPO) which has a network of nearly 600,000 providers and health care facilities nationwide.
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Question:
Does FCHP offer a qualified high-deductible health plan that's compatible with a health savings account?
Answer:
Yes, FCHP has a full array of qualified high-deductible health plans available through FCHP Care Choice.
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Question:
Does FCHP offer self-funded products?
Answer:
Yes, through FCHP’s wholly owned subsidiary, UltraBenefits, Inc., we are able to accommodate the full spectrum of alternative funding for your clients. Our funding and administrative options include Health Reimbursement Arrangement (HRA) and high-deductible administration, available with all FCHP plan design options, as well as a complete array of partial self-funding capabilities and choices.
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FCHP Direct Care is a plan with a limited provider network. This plan provides access to a network that is smaller than FCHP Select Care. In this plan, members have access to network benefits only from the providers in FCHP Direct Care. Please visit our Find a Doctor tool or consult the FCHP Direct Care provider directory to determine which providers are included in FCHP Direct Care. A paper copy can be requested by calling our Customer Service Department at 1-800-868-5200.