As a member of the Southeastern MA Health Group (SMHG), the Town offers Blue Cross Blue Shield of Massachusetts HMO and PPO health insurance plans. Open enrollment for health insurance in held in May for July 1st coverage. Normally, you can only be added to health insurance during open enrollment. However in the case of certain “life events” you can pick up coverage for you and your dependents outside the open enrollment period. Read more about what would be considered a Life Event (PDF).
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.
Summary of Coverage & Benefits
The following are Fiscal Year (FY) 2019 Summary of Coverage and Benefits for the Town’s Health Insurance plans:
- Blue Cross Enrollment Form (PDF)
- Fiscal Year 2019 Insurance Rates (PDF)
- Health Insurance Portability and Accountability Act (HIPPA) Privacy Notice (PDF)
- HMO Plan: Network Blue New England Deductible (PDF)
- HMO Plan: Network Blue New England Value (PDF)
- Mitigation Form (PDF)
- Mitigation Reminder (PDF)
- PPO Plan: Blue Care Elect Deductible (PDF)
- PPO Plan: Blue Care Elect Enhanced Value (PDF)
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. View more information on Hospital Cost Sharing (PDF).
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 visit the Blue Cross website.
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. View more information on Express Scripts mail service pharmacy.
BCBS Fitness & Weight-Loss Reimbursement
Interested in living a healthier lifestyle? Blue Cross Blue Shield of Massachusetts makes it easy with two reimbursement programs designed to help you better manage your health and reduce your risk of developing a future illness.
The Town will offer one dental plan through Altus Dental Insurance Company. In addition to the $1,000 annual maximum per participant, the plan includes a Preventive Rewards Program which covers first and second cleanings and exams, X-Rays, Fluoride Treatments and Sealants, all outside of the annual maximum.
Basic & Voluntary Life Insurance
The Town administers, through Boston Mutual Life Insurance Company, two group life insurance policies to it employees at the time of hire. They are the Basic Life Insurance Plan and the Voluntary Plan. The Basic plan provides a $4,000 Death Benefit and a $4,000 Accidental Death and Dismemberment Benefit. The Town pays 80% of the cost and the employee pays 20%. The Employee Life Option Plus (Permanent Life) Plan provides coverage up to $400,000 and is available at the employee’s expense. Policies exceeding $100,000 require a completed Evidence of Insurability forms: