Health and Insurance Benefit Information

Plan Year FY2023 (7/1/22 to 6/30/23)

Fallon Community Health announced that they would no longer offer commercial plans as of June 30, 2022, such as those plans offered to Town employees. As a result, there are significant changes to some health rates in FY23 (beginning 7/1/22). In an effort to help communicate these changes, the West Suburban Health Group voted on FY23 rates earlier this year.

If you are currently enrolled in Fallon, please be aware of the following: 

  • Fallon will not be available on July 1, 2022. You must select a new plan during open enrollment period and submit forms.
  • Blue Cross will now be the lowest cost option, however, the FY23 Blue Cross rates are still significantly higher than the FY22 Fallon rates. 

To help communicate this change, and to help employees best understand all of the health plan options offered by the Town, information sessions will be scheduled leading up to and through the Open Enrollment period this spring. Please  please check back on this site for up-to-date information. 

To view a copy of the Information Session Presentation, please click below:

Info Session Presentation(Info Session) Version en Español
FY2023 Info Session_FINALFY2023 Info Session - ESPAÑOL

FY23 Open Enrollment Zoom Presentations

FY23 Open Enrollment Info Session March 7, 2022
FY23 Open Enrollment Health Provider Presentation 3/31/2022
FY23 Open Enrollment Voluntary Benefits Presentation 4/13/2022

Where to Submit Enrollment Materials

Town Employees: 

School Employees: Upload securely via TalentEd Records (or contact to for instructions)

FY2023 Rates - Health, Dental & Group Life

FY23 Rate Chart - Effective July 1, 2022
FY22 Rate Chart - Effective July 1, 2021
FY21 Rate Chart - Effective July 1, 2020
Group Life Rates

Enrollment Forms

Harvard Pilgrim Health CareLife Insurance EOI HIPAA Release
Blue Cross/Blue ShieldTufts Health Plan
Delta DentalEyeMed Vision(vendor only allows 1st of month enrollments)
CY23 Health Savings Account (HSA) 
FY23 Flexible Spending Account (FSA)
Life Insurance application
Opt-Out Form
Life Insurance EOI
Declination Form

Enrollment Forms in Spanish

Blue Cross Blue Shield

Insurance Carrier Information

When making insurance enrollment decisions, always consult your healthcare provider and ensure they are within the specific plan’s network or click the "Find a Provider" link below. You may also reach out to the insurance carriers directly, via the Member Services number below, to ask specific coverage questions under the plans offered by the Town. Mention that you are a "prospective member" and be ready to reference the specific Group Number as specified below. If you need further assistance or clarification, please reach out to your HR Department and we may be able get further information from our Insurance Account Representative on your behalf.
Insurance Carrier
Summary of Benefits
(Qualified High Deductible)
Summary of Benefits (Benchmark)
Summary of Benefits
Summary of Benefits 
(Limited Network)
Member Services
Find a Provider



1-800-262-BLUE (select prompt 3)
High Plan:
Low Plan:



Opt-Out Program

Program Requirements (PDF) / Enrollment Form (PDF) / Declination Form (PDF)

Health Savings Account (HSA) Info

HSA GuidebookHSA Election Form
Health Equity Plan Comparison ToolGeneral info on HSA/QHDHPs

Flex Spending Account (FSA) Info

FSA Election Form (FY23)
Flexible Spending Account Overview (Spanish)
Flexible Spending Account OverviewFSA Frequently Asked Questions
Eligible Expenses and Election WorksheetDependent Care Eligible ExpensesEligible Expenses and Election Worksheet (Spanish)
Summary Plan Document (7/1/18 - 6/30/19)Summary Plan Document (7/1/19 - 6/30/20)

Other Benefits

NEW!: MyTeleMedicine

Delta Dental: Right Start 4 Kids

Diabetes Care Rewards Program

CanaRx Prescription Drug Program (see more for $0 co-pays!!)

Legal Notices

125 Summary Plan Document / 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)

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

HR Benefits Office Hours available by appointment only