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Health Insurance Plan Options
Please be advised that changes to your benefits can only be made during the first 30 days after a qualifying event (birth, death, adoption, marriage, divorce, etc.) or during open enrollment. Newly hired benefit eligible employees have 30 days from their start date to make benefit selections.
Plan Comparison Documents & Pre-Tax Plan Savings Options
FY24 Health Insurance Rates | FY24 Comparison Chart - ALL PLANS |
| Benchmark Plan comparison (FSA/HRA eligible) | High Deductible Health Plan (HSA eligible) |
|---|---|
| FY24 Benchmark Plan Comparison Chart | FY24 HDHP Comparison Chart |
| Flexible Spending Account (FSA) Information | Health Savings Account (HSA) Information |
| Health Reimbursement Account (HRA) Info | Winning with an HSA |
**Health Insurance Opt Out Application- to be eligible for the Health Insurance opt out option, employees must have had a Town of Wellesley health insurance plan for two consecutive years prior to opting out.
***Additional Insurance Opt Out form- to be eligible for the Additional Insurance opt out option, employees must have a Town of Wellesley insurance plan and must opt out of both Hospital and Accident insurance and/or dental insurance. Forms must be received by the HR office in Town Hall within 30 days of your initial eligibility date to be eligible for this program.
PLEASE NOTE: Neither opt out form listed above will be processed without an email to benefits@wellesleyma.gov indicating what needs to be dropped and when. Submitting the form on its own is not sufficient to stop coverage or deductions when it comes to opting out of benefits.
PinnacleCare is an additional resource for employees who have health insurance through the Town of Wellesley who experience a life-changing medical diagnosis. Learn more about the services PinnacleCare offers HERE.
Blue Cross Blue Shield (BCBS)
Network coverage area includes MA, RI, CT, NH, ME & VT
| BCBS Benchmark Plan (FSA/HRA eligible) Network Blue New England Deductible HMO Group Number 00-4053588 | BCBS High Deductible Health Plan (HSA eligible) Access Blue New England Saver Group Number 00-4062729 |
|---|---|
| BCBS Benchmark Summary of Benefits and Coverage | BCBS High Deductible Summary of Benefits and Coverage |
| BCBS Benchmark Plan Summary | BCBS High Deductible Plan Summary |
| CanaRx Program | CanaRx Program |
| Blue Cross Prescription Formulary | Blue Cross Prescription Formulary |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
| BCBS Preventative Drug List - medications at co-pay level (deductible does not apply) | |
| BCBS Benchmark Hospital Tiering List | $9 Generic Drug List |
| Find a Doctor* Tool requires Dr. name, zip code and Network Plan Name = Network Blue New England Deductible HMO Network = HMO Blue New England Network with Hospital Choice Cost Sharing Feature Member Service #: 800-782-3675 Customer Service #: 800-262-2583 | Find a Doctor* Tool requires Dr. name, zip code and Network Plan Name = Access Blue New England Saver Network = HMO Blue New England Member Service #: 800-782-3675 Customer Service #: 800-262-2583 |
| A Healthy Me - BCBS extras! | A Healthy Me- BCBS extras! |
| Mental Health Resources | Mental Health Resources |
| BCBS Fitness Reimbursement Form Weight Loss Reimbursement Form | BCBS Fitness Reimbursement Form |
*When searching the BCBS website for a doctor, be sure to use all the credentials above for the specific plan you are interested in. If your doctor does not appear in the online search tool, please call the customer service number listed above, give the group number of the BCBS option you are interested in and ask the representative to assist you with your doctor search.
Blue Cross Blue Shield Limited Network Plans (BCBS)
Network coverage area includes MA ONLY**
**Before selecting this plan, be sure your doctors are covered by using the "Find a Doctor" tool with the credentials specified below
| BCBS Benchmark Select Plan (FSA/HRA eligible) Network Blue New England Deductible HMO Group Number 00-4069885 | BCBS High Deductible Select Health Plan (HSA eligible) Access Blue New England Saver Group Number 00-4070369 |
|---|---|
| BCBS Benchmark Select Summary of Benefits and Coverage | BCBS High Deductible Select Summary of Benefits and Coverage |
| BCBS Benchmark Select Plan Summary | BCBS High Deductible Select Plan Summary |
| Find a Doctor* Tool requires Dr. name, zip code and Network Plan Name = Network Blue New England Deductible HMO Network = HMO Blue Select Member Service #: 800-782-3675 Customer Service #: 800-262-2583 | Find a Doctor* Tool requires Dr. name, zip code and Network Plan Name = Access Blue New England Saver Network = HMO Blue Select Member Service #: 800-782-3675 Customer Service #: 800-262-2583 |
*ALL other plan materials for this plan are the same as noted in the BCBS chart above | |
*When searching the BCBS website for a doctor, be sure to use all the credentials above for the specific plan you are interested in. If your doctor does not appear in the online search tool, please call the customer service number listed above, give the group number of the BCBS option you are interested in and ask the representative to assist you with your doctor search.
Harvard Pilgrim Health Care (HPHC HMO)
Network coverage area includes MA, RI, CT, NH, ME & VT
| HPHC Benchmark Plan (FSA/HRA eligible) Group Number 028848-0030 | HPHC High Deductible Health Plan (HSA eligible) Group Number 018992-0018 |
|---|---|
| HPHC Benchmark Plan Summary | HPHC High Deductible Plan Summary |
| CanaRx Program | CanaRx Program |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
| HPHC Hospital Tier Listing | HPHC Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Find a Doctor - HPHC Plan Type = HMO Plan Category = Tiered/Limited Plans Tiered/Limited Plans = ChoiceNet HMO-2022 | Find a Doctor - HPHC Plan Type = HMO Plan Category = Standard Plans Standard Plans = HMO or HMO Open Access |
| Mental Health Resources Fitness Reimbursement | Mental Health Resources |
Tufts Health Plan
Network coverage area includes MA, RI, NH and extended service areas in Southern ME,
Eastern VT and just over the CT border
| Tufts Benchmark Plan (FSA/HRA eligible) Group Number 45843-130 | Tufts High Deductible Health Plan (HSA eligible) Group Number 57527-130 | ||
|---|---|---|---|
| Tufts Benchmark Plan Summary | Tufts HDHP Plan Summary | ||
| CanaRx Program | CanaRx Program | ||
| Tufts Prescription Formulary | Tufts Prescription Formulary | ||
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program | ||
| Tufts Health Plan Preventative Drug List - medications at co-pay level (deductible does not apply) | |||
| Find a Doctor - Tufts Benchmark Plan | Find a Doctor - Tufts HDHP | ||
| THP Overview | Pharmacy Info | Cost Estimator | Discounts |
| Acupuncture | Fitness Rewards | Eye Care | CVS Extracare |
| Mental Health Resources | Mental Health Resources | ||
Harvard Pilgrim PPO (HPHC PPO)
| HPHC PPO Enrollment Form | HPHC PPO Plan Summary |
| Mental Health Resources | Mental Health Resources |