2025 Commercial Plans

Memorial Hermann Health Plan

The Memorial Hermann Health Plan portfolio includes a wide variety of plans, including fully insured and self-funded HMO and PPO options for employer groups, as well as Memorial Hermann Advantage HMO plans for individuals who qualify for Medicare coverage.

2025 Quick Reference Tools

• Breaking Down the Basics - view our county expansion and updated group/member eligibility.
• Urgent Care - find the appropriate care in our wide network of urgent care and retail clinics via in-person or virtual care options (phone or online).
• 2025 Underwriting Guidelines – review the current Agents Field Underwriting Guidelines.
• Contact Sheet - reach out to us with any questions or concerns.

2025 Renewals Information

• Renewal Submissions for all groups will be passively renewed in 2025 –
  For all effective dates as of January 1, 2025 forward, if no response is received, all membership will be auto-renewed into the corresponding 2025 plan(s), as indicated in the Anniversary Proposals delivered.
• For any plan or group structure changes –
  A signed Acceptance Agreement, along with any membership changes, will need to be received no later than the 1st of the effective date.
• All Small, Hybrid and Large Group renewal submissions, including new enrollments and enrollment changes, need to be sent to our Sales Installation Department at sales.installation@apex4health.org.
• Enrollment Submission Spreadsheets can now be utilized down to two (2) employees - access appropriate group enrollment spreadsheets below.
• For additional information regarding renewals or if any questions, please reach out to MHHPAccountMgmt@apex4health.org.

2025 Large Group Product Reference

• Large Group Plan Grid: HMO | PPO
• Large Group Employer Application
• Common Ownership Certification Form
• Employee Enrollment Form: English | Spanish
• Large Group Enrollment Spreadsheet
• Deductible Credit Form
• Employee Termination Form
• Employee Verification Form
• Continuity of Care Form
• Group Data Submission Agreement
• ACH Form
• All HMO Group Applications must also complete the following Disclosure Form
• All Employee Enrollments - if a SSN is not provided on the application for a dependent - must also complete the following Attestation Form.

2025 Hybrid Product Reference

• Hybrid Plan Grid: HMO | PPO
• Hybrid Employer Application
• Common Ownership Certification Form
• Hybrid ASO
• Hybrid Employee Enrollment: English | Spanish
• Hybrid Group Enrollment Spreadsheet
• Deductible Credit Form
• Employee Termination Form
• Employee Verification Form
• Group Data Submission Agreement
• ACH Form
• Continuity of Care Form
• All Hybrid Employee Enrollments - if a SSN is not provided on the application for a dependent - must also complete the following Attestation Form (Hybrid).

2025 Small Group/Metal Tier Product Reference

• Small Group/Metal Tier Plan Grid
• Small Group/Metal Tier Employer Application
• Common Ownership Certification Form
• Employee Enrollment Form: English | Spanish
• Small Group Enrollment Spreadsheet
• Deductible Credit Form
• Employee Termination Form
• Employee Verification Form
• Continuity of Care Form
• Group Data Submission Agreement
• ACH Form
• All HMO Group Applications must also complete the following Disclosure Form
• All Employee Enrollments - if a SSN is not provided on the application for a dependent - must also complete the following Attestation Form.

Please reference our Resource Center for the most current information and plan summaries, along with historical plan information from the prior plan year. 

Other Important Documents

• Certificate of Coverage - Large Group
• Certificate of Coverage - Small Group
• Service Area County Map
• Creditable Coverage Notice
• Evidence of Coverage - Large Group
• Evidence of Coverage - Small Group
• Hybrid Summary Plan Documents – HMO | PPO
• Memorial Hermann Facilities Map