The Town of Mansfield provides Health Insurance for retirees, including spouses and dependents under age 26, contributing 75% of the premium. Retiree insurance will begin on the 1st of the month following the actual retirement date.
There are currently 4 active (under age 65) plans and 2 Medicare Supplement (age 65 and over) plans. Both Active and Medicare Supplement plans include Prescription Drug coverage.
Active (under age 65)
Effective for plan year FY2016, the Affordable Care Act requires that employers provide a Summary of Coverage and Benefits (SBC) for each of its plans, to all eligible employees. This information is available here on the website, or will be provided in writing upon request. Below are FY18 Summary of Coverage and Benefits for the Town’s Health Insurance plans.
- HMO Plan: Network Blue New England Value; click here.
- HMO Plan: Network Blue New England Deductible; click here.
- PPO Plan: Blue Care Elect Enhanced Value; click here.
- PPO Plan: Blue Care Elect Deductible; click here.
- Blue Cross Enrollment Form
- For FY2018 Rates, click here: FY18 Ins Rates
- HIPAA Privacy Notice, click here
- Attached is a mitigation reminder and mitigation form.
Your medical plan gives you an opportunity to control your share for hospital care. That’s because what you pay depends on the hospital or related facility you choose. For more information, click here.
Blue Cross Blue Shield of Massachusetts provides a high-quality, affordable pharmacy benefit. The most important thing you can do is to be sure you stay informed about your medications. For more information about formularies and to use the medication lookup tool, please click this link: https://www.bluecrossma.com/wps/portal/members/using-my-plan/manage-my-plan/pharmacy-coverage/
Blue Cross Blue Shield of Massachusetts has chosen Express Scripts as your mail service pharmacy. You can order up to a 90-day supply for most long-term medications, which can save you time. You also can save money because you’ll have a smaller co-payment for most medications when you purchase them through the mail service pharmacy instead of a retail pharmacy.
For more information on Express Scripts mail service pharmacy, click this link: https://www.bluecrossma.com/wps/portal/members/using-my-plan/manage-my-plan/pharmacy-coverage/mail-service-pharmacy/
The Town of Mansfield is pleased to offer a new optional pharmacy program to employees, retirees and dependents called CanaRX. Please click here for and introduction letter, CanaRX. CanaRx is a pharmacy program that will be made available to all health insurance covered Town employees effective March 1, 2017. CanaRx was the first international prescription provider (IPP) to introduce and supply a public sector program in America.
This is an optional program which provides an alternative to Express Scripts and US pharmacies and allows employees to order prescriptions by mail from government-licensed physicians, pharmacists and pharmacies in Canada, the United Kingdom, Australia and New Zealand (Tier-1 countries as designated by Congress) to supply brand name medications, packaged and sealed by the original manufacturer, for direct delivery to all participants. All medications shipped by CanaRx are Tier-1 country safety certified for local distribution. No other sources are used.
Pharmacy drugs purchases through CanaRx are lower in price than if purchased in the United States, and are purchased for $0 co-pay.
Pharmacy orders are placed directly with CanaRx. Please click here for an CanaRx enrollment package.
Medicare Supplement (over age 65)
The Town requires retirees, including spouses and dependents, who are eligible for Medicare to apply for Medicare Part B and, if eligible, to transfer to a Medicare Supplement Plan.
- Retiree, or spouse, turning 65 will need to apply for Medicare part B three months prior to the first day of the month they will be turning 65, even if there is a possibility Medicare will be denied. If denied the letter of denial will be needed to be eligible to continue on an active plan.
For more information about Medicare go to the following website: https://www.medicare.gov/
- The person who is not 65 will continue on an individual active plan.
- If there are 3 or more people on the family plan the active family plan will remain in effect. The person turning 65 will still need to apply for Medicare Part B.
- If the Retiree dies the surviving spouse will be eligible to continue on the Towns insurance at the same cost. Surviving spouses are no longer eligible for insurance if they remarry.
- BLUE MED RX 2018 (prescription drug coverage)
- FastStart – CVS Caremark (mail order pharmacy)
- MANAGED BLUE 2018
- MEDEX 2018
The Health Insurance plans also include Fitness and Weight Loss reimbursements benefits. See below for more information and forms.
- For a Fitness Benefit Reimbursement Form use the following website link: http://www.mansfieldma.com/wp-content/uploads/Fitness_Reimbursement_Form.pdf
- For a Weight Loss Benefit Reimbursement Form use the following website link: http://www.mansfieldma.com/wp-content/uploads/Weight_Loss_Reimbursement_Form.pdf
Paper copies of the materials listed above are available in the Treasurer’s office on the 2nd floor in Town Hall. These documents are also available to e-mail. Please call 508-261-7340 or 508-851-6427 or e-mail us.
The Town offers one (1) dental plan through Delta Dental. The Dental Overview provides a description of the plan and includes the rates for FY 2018. For the Delta Dental’s summary of coverage, click here. For Delta Dental’s policy on coordination of benefits, click here. For a dental enrollment form, click here: dental-enrollment-form
Click here for FY18 dental rates.
Retirees who had Basic Life or Voluntary Life plan #14190 as an active employee may continue with these insurance(s) as a retiree.
- The Basic Life Insurance benefit decreases to $2,000 and the monthly premium decreases to 1.08 per month with the Town contributing .86 per month towards the premium.
- The Voluntary Life Insurance benefit decreases to $5,000 and the monthly premium will be $3.90 per month – 100% paid by the retiree. The dependent coverage (if applicable) premium and amount is determined on an individual basis. This plan cancels at age 75. Please contact the Treasurer’s Office for more details.
- The Voluntary Life Insurance plan # 26440 can be converted after retirement to be paid directly to Boston Mutual Life Ins. Please contact the Treasurer’s office for the application form.
In order to have Vision Insurance as a retiree you must have it as an active employee. Retiree rates apply.
Mitigation requests for retirees need to submitted to the Treasurer’s Office.
Payment of Insurance Benefits
Payment for your Insurance Benefits will be deducted from your pension check the month prior to the month of coverage provided there is enough to cover the deductions. If there is not enough to cover all insurance deductions you may pay directly to the Treasurer’s office. The payments will be due in the office the month prior to the coverage month with the exception of the Medicare Supplement plans.
Payments for the Medicare Supplement plans are required in the office by the 4th of the month prior to the coverage month. If payment is not received by the 4th a 21 day letter will be sent to you and the Health Insurance administrator and would require re-applying for the coverage.
Open Enrollment for Retirees
You may change or add Health Insurance or Dental Insurance as a retiree as follows:
- Open enrollment for the active (under age 65) Health Insurance and the Dental Insurance is typically the month of May for a July 1st start date.
- If you have coverage, notice of open enrollment and new plan rates are sent at the end of April. If you are not actively enrolled in the Towns Health or Dental plans you will not receive notification of open enrollment however if you wish to enroll you must apply during the open enrollment period for the July 1st start date.
- Open enrollment for the Medicare Supplement plans is during November of each year with a start date of January 1. Notice of new rates and open enrollment will be sent at the end of October to anyone currently enrolled in a Medicare Supplement plan.
In order to enroll in Health Insurance outside of the open enrollment periods there must be a qualifying event, i.e.: loss of coverage or a move outside of the service area.