Non-Medicare Open Enrollment (FY2019)

As previously announced, the "Rate Saver" health plans will no longer be available to West Suburban Health Group members beginning in Fiscal Year 2019 (July 1, 2018). The Benchmark plans will continue to be available, as well as a Qualified High Deductible Health Plan (QHDHP) with a Health Savings Account (HSA) for eligible employees.

This webpage will continue to be populated with up-to-date information to help you make an informed choice related to health care. Please continue to check this page or schedule an appointment with your Human Resources Department for more information.

FY2019 Open Enrollment Period

April 13, 2018 through May 11, 2018 (at noon)

 FY19 Benefits Fair!

Monday, April 23, 2018: 12pm to 5pm (PDF)

Tuesday, April 24, 2018: 10am to 3pm (PDF)

Informational Presentations

*April 5th - 3:30pm to 5:00pm - Powers Hall, Town Hall (PDF)

*April 19th - 8:30am to 10:00am - Senior Center/Center at the Heights (CATH) (PDF)

May 2nd - 12:00pm to 1:30pm - Community Room, Library (PDF)

May 8th - 3:30 to 5:00pm - Powers Hall, Town Hall (PDF)

*Spanish Interpretation Available - Please RSVP to Human Resources if interested

NEW: During the Benefits Fair two additional presentations will be held:

April 23rd - 3:00pm to 4:00pm - Selectmens' Chambers, Town Hall

April 24th - 12:00pm to 1:00pm - Selectmens' Chambers, Town Hall

General Open Enrollment Information

Enrollment Guide (PDF) / Benefits Fair - Save the Date! (PDF) / Informational Presentations (PDF) / Non-Medicare Retiree Announcement (PDF)

Health Plan Information


Active Employees (PDF) / Non-Medicare Retirees (PDF)

Comparison Charts:

Benchmark (PDF) / Qualified High Deductible Plan (PDF)

Plan Specific Information

Including contact Member Services and SBCs

Enrollment Forms

Enrollment Action Form:

Employees (PDF) / Non-Medicare Retirees (PDF)

Carrier Specific Forms:

Fallon Application (PDF) / Harvard Pilgrim Application (PDF) / Blue Cross/Blue Shield Application (PDF) / Tufts Application (PDF)

Forms for Declining Benefits

Declination Form (PDF) / Opt-Out Program Form (PDF) (must be eligible)

Flexible Spending Account (FSA)

Enrollment Form (PDF) / FY19 Open Enrollment Announcement (PDF) / FSA Benefit Overview (PDF) / Benefit Strategies, LLC. Resources and Forms / FSA Eligible Expenses (PDF) / Dependent Care Eligible Expenses (PDF) / Summary Plan Document (1/1/18 - 6/30/18) / Summary Plan Document (7/1/18 - 6/30/19)

Health Savings Account (HSA) / High Deductible Health Plan

Presentation to WSHG on 11/30/17 (VIDEO) / PowerPoint Slides from NFP Corp Presentations (PDF) / HealthEquity HSA Guidebook (PDF) / Harvard Pilgrim - Understanding your HSA / Blue Cross HSA-QHDHP Plan Tutorial / Harvard Pilgrim - QHDHP / BCBS Preventative Drug List / HPHC Preventative Drug List (PDF) / FALLON Preventative Drug List (PDF) / TUFTS Preventative Drug List (PDF) / Pro-Rated Method of Calculation (excerpt from HealthEquity HSA Guidebook) (PDF) / West Suburban Health Group (WSHG) Information on HSA/QHDHPs

Tools and Resources
For Estimates ONLY 

QHDHP vs. Benchmark Calculator (Excel Format) (PDF)

Online Health Plan Comparison Tool (by HealthEquity)

HSA Contribution Guide and Tool (PDF)

Scenarios, results and calculations presented in these tools are example estimates only. Individual results may vary. Nothing in these tools are intended as legal, tax, financial, medical or marital advice. Always consult a professional when making life changing decisions.

Voluntary Benefits

Delta Dental Plan Comparison (PDF)

Delta Enrollment Form (PDF) - Boston Mutual Life and Accident Insurance


CanaRx Prescription Drug Program - Benchmark plan members are eligible to participate in the CanaRx program. High Deductible plan members are not eligible to participate in CanaRx at this time.

Diabetes Care Rewards Program - Benchmark plan members are eligible to participate in the Diabetes Care Rewards program. High Deductible Plan members are eligible to participate in the Diabetes program; however, only the diabetic medication on the carrier's Preventive Drug List will be available at $0 co-pay. Because Fallon's Preventive Drug List does not include any diabetic medications or supplies, the Diabetes Care Rewards Program is not eligible for Fallon High Deductible plan members at this time. 

 Required Notices

Affordable Care Act - Market Place Notice (PDF) / CHIP Notice (PDF) / HIPAA Privacy Notice (PDF) / COBRA Notice (PDF) / HIPAA Special Enrollment Rights (PDF) / Notice of Patient Protections (PDF) / Summary of Benefits and Coverage (SBC) (PDF) / Women's Health and Cancer Rights Act (WHCRA) (PDF) / Summary of Benefits and Coverage (SBCs) 

Insurance Carrier
Customer Service
Find a Provider
Fallon Community Health Plan


Plan: Select Care and Direct Care

Harvard Pilgrim Health Care


Plan: HMO or PPO

Tufts Health Plan


Plan: HMO

 Blue Cross/Blue Shield


Plan: HMO Blue New England

Delta Dental1-800-872-0500Plan: Delta Dental Premier
AflacRay DeRosa (Agent): 617-658-1834NA

Please visit the West Suburban Health Group website for additional insurance information

Human Resources Benefits Office Hours (Appointments encouraged)

Tues, Weds, Thurs, 1:00pm to 4:30pm