Combined Organization of Tufts Health Plan and Harvard Pilgrim Health Care Announce Full Year 2020 Financial Results

Watertown/Wellesley Mass., March 1, 2021 – The combined organization of Tufts Health Plan and Harvard Pilgrim Health Care today reported an adjusted net income of $32.8 million for the 12 months ended Dec. 31, 2020. Adjusted net income includes an operating loss of $21.9 million and investment income of $73.7 million, excluding mark-to-market investment gains and losses on equity securities, with revenues of $9.2 billion. *Membership was 2.3 million combined for both organizations at the end of 2020. Unrealized gains on equity securities for the year was $114.4 million.

“With the combination of Tufts Health Plan and Harvard Pilgrim Health Care effective January 1, 2021, we have made tremendous progress in putting the foundational pieces of our combined organization in place,” said Umesh Kurpad, chief financial officer of the combined organization. “We look forward to sharing updates on this progress as well as introducing initiatives and programs benefiting our members and the communities we serve.”

“The full year 2020 financial results of the combined organization reflect the vast diversity of our business and reflects different financial outcomes; however, our year-end results are in-line with our expectations,” Kurpad continued. “We anticipate the pandemic will continue to have a significant impact on our medical costs pertaining to COVID-19 treatment, vaccine administration and deferred care, throughout 2021 and 2022. While the pandemic continues to have an impact on our members, providers, customers and our communities, with the vaccine distribution currently under way, there is certainly light at the end of the tunnel.”

These financial results compared to a year ago when the combined organizations reported an adjusted net income of $121.6 million for the year ending Dec. 31, 2019, which comprised an operating income of $47.7 million and investment income of $69.2 million, excluding mark-to-market investment gains and losses on equity securities, with revenues of $8.7 billion. Membership was 2.3 million at the end of 2019.

*Membership numbers include members of Tufts Health Freedom Plan. Tufts Health Plan divested its interest in Tufts Health Freedom Plan on Jan. 1, 2021.

The combined organization continues to mobilize around the COVID-19 pandemic to provide support to its members, employer groups, employees and the communities it serves. In 2020, both organizations and their foundations, Tufts Health Plan Foundation and The Harvard Pilgrim Health Care Foundation, provided close to $60 million to support COVID-19 initiatives across the region.

Additionally, the Foundations provided a combined $5 million to support initiatives that address racial inequities, health disparities and provide support to Black and Brown Communities.

2020 Member, Employer and Community Support Highlights

• Provided $1 million to the New Commonwealth Racial Equity and Social Justice Fund through the Harvard Pilgrim Health Care Foundation
• Provided more than $1 million to support racial and social justice funds, including the New Commonwealth Racial Equity and Social Justice Fund, the Latino Equity Fund and the Asian Community Fund, through Tufts Health Plan Foundation
• Provided $2 million to nonprofit organizations addressing basic needs, like access to food and inequities in housing and services, and those working with older people and other populations most affected by the pandemic, through Tufts Health Plan Foundation
• Provided more than $4 million for COVID-19 relief and food access efforts by supporting community and nonprofit organizations through the Harvard Pilgrim Health Care Foundation
• Provided $3 million through the Harvard Pilgrim Health Care Foundation to support community health centers focusing on those providing care to predominately Black and Brown communities, as well as centers that provide care for vulnerable populations, to support equity and equality in accessing health care, and address health disparities
• Harvard Pilgrim Health Care provided independent primary care practices with $3 million in financial support to assist with opening their practices in accordance with COVID-19 guidelines
• Harvard Pilgrim Health Care provided over $28.7 million in premium credits to fully-insured employer groups and Medicare Supplement members
• Both organizations waived COVID-19 testing and treatment cost-sharing and removed out of pockets expenses for telehealth services

2020 Organizational Highlights

• Harvard Pilgrim and Tufts Health Plan named top place to work by The Boston Globe
• Harvard Pilgrim and Tufts Health Plan both received a perfect score of 100 percent on the 2020 Corporate Equality Index (CEI), a national benchmarking survey and report on corporate policies and practices related to lesbian, gay, bisexual, transgender and queer (LGBTQ) workplace equality
• For an unprecedented sixth year in a row, the Centers for Medicare and Medicaid Services (CMS) rated Tufts Medicare Preferred HMO and Senior Care Options 5 out of 5 Stars in its annual Star Quality Ratings for 2021. With 400 plans rated nationally, this puts Tufts Health Plan’s Medicare plans in the top five percent nationally. Tufts Health Plan is one of only two plans in the country to receive this rating for six years in a row.

About the new combined organization

The combination of Tufts Health Plan and Harvard Pilgrim Health Care represents the coming together of two of New England’s most iconic nonprofit health care companies. Representing nearly 90 years of service to our members and the community, together we are building upon our diverse legacies and innovative collaboration by making it our purpose to guide and empower healthier lives for our members – no matter their age, health, race, identity, or income.

We strive to be a different kind of nonprofit health and wellbeing company, with a broad range of health plans, and innovative tools that make navigating health and wellbeing easier, guiding our members at every step of their health care journey to better health outcomes. We are committed to providing high-quality and affordable health care, improving the health and wellness of our members, and creating healthier communities throughout New England.