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HUMAN RESOURCES DEPARTMENT humanresources@amherstma.gov
September 5, 2007
HEALTH
INSURANCE OPEN ENROLLMENT
All employees who are eligible for benefits, including
those who have previously waived health insurance benefits, may enroll during
the open enrollment period. Open
enrollment will be from now until May 11, 2007.
All changes made during Open Enrollment will be effective
The employee Insurance Advisory Committee is currently
reviewing options for dental plans and we would anticipate a recommendation
from them prior to the next open enrollment.
Another reminder – The CanaRX mail order program for
prescription drugs is available to all employees, retirees, and their family
members who are enrolled in one of our health plans. The website for this program is www.AmherstMeds.com There
are no co-pays for you to pay with these prescriptions.
For changes and new enrollments, Town of Pelham and all School
employees should contact Maggie Jaeger at the Middle School (413-362-1895) or
email her at jaegerm@arps.org; all Amherst Municipal employees should contact Theresa Fleurent,
Accounting Office (413 -259-3026) or email her at fleurentt@amherstma.gov. The new rates will be reflected
in employee payroll deductions in June.
While the following information is meant to answer most
commonly asked questions, representatives from both plans will be available to
answer your questions:
Blue Cross Blue Shield Harvard
Pilgrim Health Care
Customer Service Representatives Account Representative: David
M. Kieser
www.bcbsma.com www.harvardpilgrim.org
For those of you planning retirement, our group requires
enrollment in a health insurance membership at the time of retirement
in order to continue that coverage into retirement. Also a reminder for those nearing age 65 – we
highly recommend that you sign up for Medicare Part B when you become
eligible. Please contact Theresa
Fleurent for additional information.
As you evaluate your health care needs and which plan
would best suit those needs, we also encourage to you consider enrollment in
your Section 125 Flexible Spending Account plan which enables eligible
employees to set aside pre-tax funds through payroll
deduction to cover the cost of childcare, co-pays, prescription eye ware
(glasses, contact lens), and some over the counter medications as provided for
under the Internal Revenue Service regulations.
Ms. Jaeger and Ms. Fleurent can provide additional information for plans
you may be eligible for.
Base Premium Rate |
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Individual |
$523.91 |
$561.75 |
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$523.91 |
$582.12 |
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Family |
$1,253.01 |
$1,343.49 |
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$1,253.01 |
$1,392.24 |
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EMPLOYEE PAYS |
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Individual |
$94.96 |
$140.44 |
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$94.96 |
$145.54 |
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Family |
$227.12 |
$335.88 |
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$227.12 |
$348.06 |
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Deficit Surcharge Rate |
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Individual |
$19.90 |
$21.34 |
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$19.90 |
$22.11 |
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Family |
$47.60 |
$51.04 |
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$47.60 |
$52.88 |
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EMPLOYEE PAYS |
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Individual |
$3.90 |
$5.34 |
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$3.90 |
$4.42 |
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Family |
$9.32 |
$12.76 |
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$9.32 |
$10.58 |
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Total Employee Monthly
Rates |
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Individual |
$98.86 |
$145.78 |
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$98.86 |
$149.96 |
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Family |
$236.44 |
$348.64 |
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$236.44 |
$358.64 |
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Total Biweekly
deduction |
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Individual |
$49.43 |
$72.89 |
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$49.43 |
$74.98 |
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Family |
$118.22 |
$174.32 |
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$118.22 |
$179.32 |
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Dependent Coverage |
Dependent
coverage to age 19; to age 25 if full time student on all plans |
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YOU PAY |
YOU PAY |
YOU PAY |
YOU PAY |
YOU PAY |
YOU PAY |
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Deductible |
None |
None |
$100 Individual |
None |
None |
$100 Individual |
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$200 Family |
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$200 Family |
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Calendar Year
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None |
None |
$1,000 per member |
$1,000 Individual |
None |
$1,000 Individual |
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CoinsuranceMaximum |
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$2,000 per family |
$2,000 Family |
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$2,000
Family |
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Lifetime Benefit Maximum |
None |
None |
None |
None |
None |
None |
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INPATIENT |
YOU PAY |
YOU PAY |
YOU PAY |
YOU PAY |
YOU PAY |
YOU PAY |
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Hospital Care Semi-private
room & board, surgical services, x-rays, laboratory tests, anesthesia,
drugs & medications, physician’s services, maternity care, intensive care
services |
Nothing |
Nothing |
20% coinsurance** Nothing (no deductible) for emergency/ accident admissions |
Nothing |
Nothing |
20% coinsurance** |
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