FY2025 Open Enrollment Information
Open Enrollment- FY 2025, Effective July 1, 2024
For Employees, Non-Medicare Eligible Retirees and Dependents, and COBRA Participants
Open Enrollment for FY2025 will be held this year from May 1, 2024 through May 24, 2024. During this period you may choose or change group health insurance coverage and/or elect to participate in a flexible spending account (FSA).
Rate Charts
Regulation Regarding Retiree Health Insurance Eligibility
HIPAA Notice of Privacy Practices
Notice of Available Coverage- Women’s Health and Cancer Rights Act Notice
Medicare D- Important Information About Your Health Insurance
Section 125 Premium Only Cafeteria Plan Document
Section 125 Enrollment/Waiver Form
Health Insurance Opt-Out Information
Flexible Spending Accounts (FSA)
- Flexible Spending Account Enrollment Form
- FSA Eligible Expenses
- FSA Dependant Care Qualifications
- Acknowledgement
- TASC FSA Glossary of Terms
Harvard Pilgrim Summary of Benefits and Coverage
- Harvard Pilgrim Benefits at a Glance
- Harvard Pilgrim HMO
- Harvard Pilgrim Focus HMO
- Harvard Pilgrim PPO
- Harvard Pilgrim Enrollment Form
- Harvard Pilgrim Fitness Reimbursement
- Harvard Pilgrim Living Well Program
- Harvard Pilgrim Good Measures Healthy Weight Program
Retiree Senior Plan
Health Reimbursement Arrangement
- Health Reimbursement Arrangement (HRA) Summary Plan Description
- HRA Reimbursement Procedure
- HRA Claim Form
Delta Dental Premier
- Delta Dental Premier Voluntary Enhanced Table Plan
- Delta Enrollment Form
- Amplifon Hearing Health Care Discount
- Sonic Discount
Deferred Compensation Plans
- Massachusetts Deferred Compensation SMART PLAN
- ICMA-Mission Square Retirement Deferred Compensation Plan
If you wish to enroll in or change Health or Dental plans and/or a Flexible Spending Account (FSA), or need additional information, please contact the Treasurer’s Office at Town Hall at (508)393-5047. Please note that if no change is made to your current health or dental plan selection, no further action or completion of any insurance form is required. However, if you wish to contribute to a FSA for the period of July 1, 2023 through June 30, 2024, you must complete a new FSA enrollment form.