Weekly insurance premiums for more than 1,100 workers employed by the city of Cambridge increased 21.5 percent for individual plans and 23.3 percent for family plans as the employees were moved from the Tufts Health Plan – which had been the least expensive available option for Cambridge workers – to Harvard Pilgrim Health Care in April. The move followed a consolidation at the insurance plans’ parent company, Point32Health. As workers grapple with the change, the city has taken small steps toward reviewing its insurance offerings.
The switch has caused workers to pay more and have less choice when it comes to insurance, said Chris Montero, president of the Cambridge Education Association. Montero said he is paying $126 more per month for Harvard Pilgrim than he did for Tufts; this additional cost comes out to $1,517 each year.
“For many of us who make close to or at a living wage, that essentially wipes out your cost-of-living increase,” Montero said. “For our members who make a $32,000 starting salary … I don’t know how you square that. I don’t know where that money comes from.”
At its full cost rate, Harvard Pilgrim charges $966 per month for the individual plan and $2,647 monthly for the family plan. Cambridge also offers Blue Cross Blue Shield-HMO Blue New England at $1,151 for individuals and $2,948 for families, and Blue Cross Blue Shield-Blue Choice at $1,537 for individuals and $3,920 for families. The actual cost varies from worker to worker since the city picks up part of the cost, depending on the percentage share it pays.
Tufts had cost approximately $795 per month for the individual plan and $2,148 monthly for the family plan.
Most employees on Tufts had selected that plan because it covered their basic needs for the cheapest cost available, Montero said. “Working people can’t afford the best health insurance, so we do what we can.”
Reasoning for the change
The insurance change was not initiated by the city; Point32Health combined Tufts and Harvard Pilgrim in 2021 to “improve access to health care throughout the region,” said Kathleen Makela, Point32Health’s director of public relations, in an email to Cambridge Day.
Now that the plans have been combined, Harvard Pilgrim is focused on employer-sponsored plans such as Cambridge’s, whereas Tufts centers around Medicare, Medicaid, exchange products and other government-sponsored plans, Makela said. Point32Health migrated all employer-sponsored plans to Harvard Pilgrim in the past several years.
Cambridge’s communication
When Cambridge employees learned about the switch, “a lot of people were frustrated, scared and worried because, obviously, health insurance is expensive and a source of anxiety for most Americans,” Montero said.
The city notified employees of the change in December, explaining the timing of the switch and listing Harvard Pilgrim benefits that Tufts did not have. Employees did not hear that premiums would increase until an Insurance Advisory Committee meeting in January of this year, said Clara Hendricks, president of the Cambridge Public Library Staff Association.
The city says there was warning. “The changes in premiums were communicated in advance of and during the winter 2025 open enrollment cycle, which is the only time of the year that active city/school employees and non-Medicare eligible retirees are allowed to make voluntary changes to health insurance selections, unless there is a qualifying life event,” said Jeremy Warnick, Cambridge’s director of media relations and content strategy, in an email.
Some Cambridge administrators and human resources workers had learned about the changes in January 2023, when Tufts and Harvard Pilgrim representatives discussed a timeline of planned merger effects at an annual renewal meeting. The representatives of Cambridge and Point32Health met several times in late 2023 and 2024 to begin the integration process. The move to Harvard Pilgrim, scheduled originally for April 2024, was delayed a year “at the request of the city to more effectively manage and communicate changes for staff,” Warnick said.
At the Insurance Advisory Committee meeting in January, Cambridge chief people officer Raecia Catchings and assistant director of benefits administration Barbara Brown said they hoped to increase communications with health insurance companies. This move would aim to get information about rate renewals earlier, said Hendricks, who attended the meeting.
Catchings and Brown talked about hiring a benefits broker – a welcome move, Hendricks said, as it “would make sure the benefits are up to date and potentially get the best prices, and could mean getting an additional lower-cost plan as a replacement to Tufts.”
Since this meeting, the city has followed through and “engaged a benefits broker to review all plans and provide recommendations,” Warnick wrote.
In February, city representatives held information sessions in different formats to help employees understand the changes. Montero said he gives the city credit for trying to inform its workers.
“My frustration and my issue isn’t with the city,” Montero said. “It’s with the system we live under in this country generally, and specifically the fact that we work really hard to care for other people’s kids – and we need to make sure that we have what we need to take care of our own families.”
Unions prepare to negotiate
Some city unions are taking the insurance change into consideration as they approach upcoming contract negotiations.
Although the library worker union was aware of the insurance change as the most recent contract was finalized, it ratified the contract before finding out about the significant increases to premiums.
Unless the city works to find a third, lower-cost option soon, the insurance change “is going to have to be a consideration when we ask for money in the next contract,” Hendricks said. “If we had known about what the actual numbers would look like, we may not have settled for what we did.”
The Cambridge Education Association is entering contract negotiations for all members this coming school year, and the insurance change has informed its preparation.
“We’re already starting to consider what proposals to craft around making health insurance less of a burden and more of a source of security for people, which is what insurance is supposed to be,” Montero said.
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