Non-Medicare Eligible Retiree Health Plans

Please be advised that changes to your benefits can only be made during the first 30 days after a life event (birth, death, adoption, marriage, divorce, etc.) or during open enrollment. 

Questions can be directed to Town Hall Human Resources at (781) 431-1019, ext. 2236 or by emailing benefits@wellesleyma.gov . All enrollment forms should be sent to Human Resources, benefits@wellesleyma.gov, fax 781-431-8643, or by mail 525 Washington St. Wellesley, MA 02482


GB-Pay a Bill


FY24 Retiree Heath Insurance Rates


Plan Comparison Documents & Pre-Tax Plan Savings Options

FY24 Comparison Chart - ALL PLANS 

Benchmark Plan comparison (HRA eligible)High Deductible Health Plan (HSA eligible)
FY24 Benchmark Plan Comparison Chart FY24 HDHP Comparison Chart 
Health Reimbursement Account (HRA) InfoHealth Savings Account (HSA) Information

Winning with an HSA


Blue Cross Blue Shield (BCBS) - www.home.bluecrossma.com

Network coverage area includes MA, RI, CT, NH, ME & VT

BCBS Benchmark Plan (HRA eligible)
Group Number 00-4053588
BCBS High Deductible Health Plan (HSA eligible)
Group Number 00-4062729
BCBSBCBS Benchmark Enrollment FormBCBSBCBS HDHP Enrollment Form
BCBS Benchmark Summary of Benefits and CoverageBCBS High Deductible Summary of Benefits and Coverage
BCBS Benchmark Plan SummaryBCBS High Deductible Plan Summary

BCBS Preventative Drug List - medications at co-pay level (deductible does not apply)

$9 Generic Drug List
Blue Cross Prescription FormularyBlue Cross Prescription Formulary
Good Health Gateway Diabetes ProgramGood Health Gateway Diabetes Program
CanRx ProgramCanRx Program
Find a Doctor*
Tool Requires Dr. name, zip code and network
Plan Name = Network Blue New England Deductible HMO
Network = Network Blue New England with Hospital Choice Cost Share Feature

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

Customer Service #: 800-262-2583  

*When searching the BCBS website for a doctor, be sure to use all the credentials listed 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 in your doctor search. 


Blue Cross Blue Shield Limited Network Plans (BCBS) - www.home.bluecrossma.com

Network coverage area includes MA ONLY**

BCBS Benchmark Select Plan (HRA eligible)
Group Number 00-4069885
BCBS High Deductible Health Select Plan (HSA eligible)
Group Number 00-4070369
BCBSBCBS Select Benchmark Enrollment FormBCBSBCBS HDHP Select Enrollment Form
BCBS Benchmark Select Summary of Benefits and CoverageBCBS 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

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

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 listed 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 in your doctor search.


Harvard Pilgrim Health Care (HPHC HMO) - www.harvardpilgrim.org

Network coverage area includes MA, RI, CT, NH, ME & VT

HPHC Benchmark Plan (HRA eligible)
Group Number 028848-0030
HPHC High Deductible Health Plan (HSA eligible)
Group Number 018992-0018
HPHCHPHC Benchmark Enrollment FormHPHCHPHC HDHP Enrollment Form
HPHC Benchmark Plan SummaryHPHC High Deductible Plan Summary
CanRx Program CanRx Program
Good Health Gateway Diabetes ProgramHPHC Preventative Drug List - medications at co-pay level (deductible does not apply)
HPHC Hospital Tier ListingGood Health Gateway Diabetes Program
Find a Doctor
Plan Type = HMO
Plan Category = Tiered/Limited Plans
Tiered/Limited Plans = ChoiceNet HMO-2022
Find a Doctor
Plan Type = HMO
Plan Category = Standard Plans
Standard Plans = HMO or HMO Open Access 



Harvard Pilgrim PPO (HPHC PPO) - www.harvardpilgrim.org

Nationwide network coverage

HPHC PPO
Group Number 033318-0010
HPHC Opens in new window
HPHC PPO Enrollment Form

HPHC PPO Plan Summary
Find a Doctor
Plan Type = PPO
Plan Category = Standard Plans
Standard Plans = PPO
*ALL other plan materials for this plan are the same as noted in the HPHC chart above



Tufts Health Plan - www.tuftshealthplan.com

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 (HRA eligible)
Group Number 45843-130
Tufts High Deductible Health Plan (HSA eligible)
Group Number 57527-130
TUFTS logoTufts Benchmark Enrollment FormTUFTS logoTufts HDHP Enrollment Form
Tufts Benchmark Plan SummaryTufts HDHP Plan Summary
CanRx Program Tufts Health Plan Preventative Drug List - medications at co-pay level (deductible does not apply)
Tufts Prescription FormularyTufts Prescription Formulary
Good Health Gateway Diabetes ProgramGood Health Gateway Diabetes Program

CanRx Program
Find a Doctor - Tufts Benchmark PlanFind a Doctor - Tufts HDHP