2024 INSURANCE OPEN ENROLLMENT
OPEN ENROLLMENT:
Open Enrollment occurs during the month of April and is your annual opportunity to add or change medical, dental and/or vision plans. The only other opportunity you have to make these changes is when you experience a qualifying life event (i.e. birth or adoption of a child; marriage; divorce; loss of coverage).
If you are currently enrolled in a plan listed and do not want to make any changes, then NO ACTION is required;
If you take advantage of our Flex Spending plan, please note that we need a new Flex Spending application every year.
Please do not email forms with Social Security numbers-it is best to use inter-office mail or drop off in person.
If you do NOT have Health Insurance with the Town of Walpole - please complete a Declination of Insurance form. We need this form submitted every year due to the rules and regulations of the Affordable Care Act.
COVERAGE CHANGES:
If you choose to change any part of your coverage, you must do so during the Open Enrollment Period. During this Open Enrollment period you may:
- Change medical and/or dental coverage; select from individual or family coverage
- Enroll or re-enroll in the Flexible Spending Account(s)
- Enroll yourself and dependent(s) on a medical and/or dental plan
- Terminate medical and/or dental coverage for yourself and dependent(s)
- Update your address if you have recently moved
- Update your beneficiary for your Life Insurance Policy
OPEN ENROLLMENT FORMS:
2024 eKit: information regarding our Medical/Dental/Vision insurance including Summary of Benefits for all of our plans & other helpful information.
Employee Open Enrollment Letter
Retiree Open Enrollment Letter
Insurance Rates July 1, 2024 - June 30, 2025
Declination Of Health Insurance Form
BLUE CROSS BLUE SHIELD FORMS:
Please note that if you are adding a spouse to your plan, we will need a copy of your marriage certificate. If you are adding a dependent to your plan, we will need a copy of the dependents birth certificate.
Summary of Benefits - Network Blue NE $100 Deductible
Summary of Benefits - Network Blue NE $500 Deductible
Summary of Benefits - HMO Blue Select Benchmark $500 Deductible
Summary of Benefits - Blue Care Elect $500 Deductible (PPO)
Enrollment/Change Form - you only need to complete this if you are enrolling on our insurance plan for the first time OR making changes to your insurance plan
BCBS - DENTAL BLUE FREEDOM FORMS:
Enrollment Form - Check the Dental Blue Freedom box and fill out the information below
FLEX SPENDING FORMS:
BLUE 20/20 VISION FORMS:
Diabetic Care Rewards Program:
Good Health Gateway Information
OPT-OUT PLAN:
Employees who are currently enrolled on the Town’s health insurance program, who are eligible, and participate in the opt-out program, will receive $1,500 per plan year for an individual plan or $3,500 per plan year for a family plan (or a pro-rated amount depending on the date of participation) if they no longer take health insurance through the Town of Walpole.
To qualify for this program, you must meet all of the following requirements:
Currently be enrolled on a health insurance plan through the Town of Walpole for at least two consecutive years immediately preceding the requested date of cancellation.
Provide proof of insurance for creditable health insurance coverage through a plan not offered by the Town of Walpole.
See the Opt-Out Plan document for more information. If you wish to participate in the Opt-Out please complete the Health Insurance “Opt-Out” Application form.
COMMENTS OR QUESTIONS:
If you have any questions or comments regarding Open Enrollment or our Insurance plans, please email Benefits Coordinator Erin McGee - emcgee@walpole-ma.gov or call (508)660-7294