Town of


AMHERST                Massachusetts

HUMAN RESOURCES DEPARTMENT                                                        humanresources@amherstma.gov

4 BOLTWOOD AVENUE                                                                              413 259-3009; FAX  413  259-2418               

AMHERST, MA 01002-2302                                                                     Director:  Kay Zlogar

                                                                                      zlogark@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 July 1, 2007.  Health Insurance rates are included in the attached information; monthly dental rates will be $28.00 individual and $71.00 family.

 

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

1-800-486-1136                                            1-888-333-4742

 

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

 

 

 

 

 

 

   Individual

$523.91

$561.75

 

$523.91

$582.12

 

   Family

$1,253.01

$1,343.49

 

$1,253.01

$1,392.24

 

EMPLOYEE PAYS

 

 

 

 

 

 

   Individual

$94.96

$140.44

 

$94.96

$145.54

 

   Family

$227.12

$335.88

 

$227.12

$348.06

 

Deficit Surcharge Rate

 

 

 

 

 

 

   Individual

$19.90

$21.34

 

$19.90

$22.11

 

   Family

$47.60

$51.04

 

$47.60

$52.88

 

EMPLOYEE PAYS

 

 

 

 

 

 

   Individual

$3.90

$5.34

 

$3.90

$4.42

 

   Family

$9.32

$12.76

 

$9.32

$10.58

 

 

 

 

 

 

 

 

Total Employee Monthly Rates

 

 

 

 

 

 

   Individual

$98.86

$145.78

 

$98.86

$149.96

 

   Family

$236.44

$348.64

 

$236.44

$358.64

 

Total Biweekly deduction

 

 

 

 

 

 

   Individual

$49.43

$72.89

 

$49.43

$74.98

 

   Family

$118.22

$174.32

 

$118.22

$179.32

 

Dependent Coverage

Dependent coverage to age 19; to age 25 if full time student on all plans

 

YOU PAY

YOU PAY

YOU PAY

YOU PAY

YOU PAY

YOU PAY

Deductible

None

None

$100 Individual

None

None

$100 Individual

 

 

 

$200 Family

 

 

$200 Family

 

 

 

 

 

 

 

Calendar Year 

None

None

$1,000 per member

$1,000 Individual

None

$1,000 Individual

CoinsuranceMaximum

 

 

$2,000 per family

$2,000 Family

 

 $2,000 Family

 

 

 

 

 

 

 

Lifetime Benefit Maximum

None

None

None

None

None

None

 

 

 

 

 

 

 

INPATIENT

YOU PAY

YOU PAY

YOU PAY

YOU PAY

YOU PAY

YOU PAY

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**