Broker Newsletter - October 2025
Your October Annual Enrollment Period (AEP) Update
We want to make it easier for you to provide Tufts Health Plan as a solution to your clients. To help support your hard work, here is what we thought you should know this month:
AEP is here
Don’t hesitate to reach out to Broker Support with any questions. We’re here to help you get the information and materials you need. Thank you for everything you do each year during the busy AEP season.
Medicare Sales Manager (Brokers) – Lenieve Henry
857-283-2465
Lenieve.Henry@point32health.org
Duals - SCO & One Care Broker Relationship Manager – Juraci Capataz
781-980-8500
Juraci.Capataz@point32health.org
Broker Relationship Manager - Peter Swiniarski
857-360-5659
peter.swiniarski@point32health.org
Broker Relationship Manager - Gerald Lodge
617-800-5368
gerald.lodge@point32health.org
Medicare Broker Support
1-833-984-2387
medicarebrokersupport@point32health.org
SCO and One Care – everything you need to know
Find all the Tufts Health Plan Senior Care Options (SCO) plan information you need:
SCO documents such as the Formulary, ANOC, and more can be found on our documents page:
Use our One Care landing page as a one-stop resource for members transitioning from MMP to D-SNP, including information about ID cards, new plan benefits, 2026 plan documents, FAQs and more.
Important: RTS for SCO and One Care
If you are planning to sell Duals products for 2026 (SCO and One Care), make sure to sign the contract addendums at the links below. Both contracts need to be signed in order to be Ready to Sell (RTS) for SCO and One Care:
Medicare Advantage Requirements Addendum
Massachusetts Medicaid Material Addendum
Please complete and return the signed addendums to Medicare Broker Support as soon as possible. Important to remember:
- You will need to sign and return the documents to be considered RTS for SCO and One Care.
- The Duals Products Addendums can be filled electronically via Adobe. Click the link above, save the file to your computer and open in Adobe to digitally sign. Alternatively, you may print, sign and scan back to us.
- All signed documents can be sent directly to Medicarebrokersupport@point32health.org.
If you have any questions, contact Medicare Broker Support, Lenieve Henry at Lenieve.Henry@point32health.org, or Juraci Capataz at Juraci.Capataz@point32health.org.
Milford Regional Physician Group
As you may already know, effective December 31, 2025, 86 primary care providers (PCPs) from Milford Regional Physician Group will be terming from the Tufts Health Plan HMO, PPO and One Care networks. (SCO members are not impacted.) Specialists and Milford Regional Hospital will remain in-network.
- Affected Members: 1,735 HMO, 292 PPO and 28 One Care
- Scope: PCPs only; specialists and hospital services are unaffected
- Member Communications: A formal letter was sent to members on September 25th
Review a copy of the letter sent to members
Commissions overview
Tufts Health Plan made the difficult decision to discontinue our $0 Tufts Medicare Preferred Access PPO plan and to make some 2026 plans non-commissionable. Below is an outline of the commissionable and non-commissionable plans for your reference:
Discontinued Plans:
- Tufts Medicare Preferred Access PPO
- Tufts Medicare Preferred HMO Saver Rx
List of Non-Commissionable Plans:
- Massachusetts PPO (H9907) – Tufts Medicare Preferred PPO Rx
- Massachusetts HMO (H2256) – Tufts Medicare Preferred HMO Smart Saver
List of Commissionable Tufts Medicare Preferred HMO Plans at 2026 Fair Market Value:
- Prime Rx Plus
- Prime Rx
- Prime No Rx
- Value Rx
- Value No Rx
- Basic Rx
- Basic No Rx
List of Commissionable DUAL ELIGIBLE plans at 2026 Fair Market Value:
- Massachusetts SCO (H8330) – Tufts Health Plan Senior Care Options (HMO-DSNP)
- Massachusetts One Care DSNP (H5314) – Tufts Health One Care (HMO-DSNP)
Renewals:
- We will continue to pay renewals on all existing members at 2026 Fair Market Value
These updates will not impact Harvard Pilgrim Health Care Medicare Supplement sales.