Forms & Links

Documents

News
$9 Generic Prescriptions for BCBS Members

Wellness
Spring Walking Challenge
Colonoscopy Incentive
Heart Health
MMHG Wellness Newsletter #1
MMHG Wellness Newsletter #2

Claim Forms
Flexible Spending Account Information & Claim Form

Mitigation Fund Claim Form
BCBS Fitness Benefit Claim Form
HPHC Fitness Benefit Claim Form

Summaries of Benefits and Coverages for FY 2014
FY 2014 Insurance Rates

FY 2014 SBC Harvard Pilgrim Rate Saver

FY 2014 SBC Harvard Pilgrim Benchmark
FY 2014 SBC Harvard Pilgrim Medicare Enhance - coming soon
FY 2014 SBC BCBS Network Blue Rate Saver
FY 2014 SBC BCBS Network Blue Benchmark

FY 2014 SBC BCBS PPO Rate Saver
FY 2014 SBC BCBS PPO Benchmark
FY 2014 SBC Medex

FY 2014 Comparison of Benefits - HMO plans
FY 2014 Comparison of Benefits - PPO plans
FY 2014 Comparison of Benefits - Medigap plans

Summaries of Benefits for FY 2013
FY 2013 Health Insurance Rules
FY 2013 Health Insurance Rates

FY 2013 Comparison of Benefits - HMOs
FY 2013 Network Blue Rate Saver
FY 2013 Network Blue Benchmark
FY 2013 Harvard Pilgrim Rate Saver
FY 2013 Harvard Pilgrim Rate Saver Pharmacy
FY 2013 Harvard Pilgrim Benchmark
FY 2013 Harvard Pilgrim Benchmark Pharmacy

FY 2013 Comparison of Benefits - PPOs
FY 2013 Blue Care Elect PPO Rate Saver
FY 2013 Blue Care Elect PPO Benchmark

FY 2013 Medicare Supplemental Plans - Comparison of Benefits
FY 2013 Medex III - new benefits added March 1, 2013
Medicare Plans Creditable Prescription Coverage

Employment Application (PDF)
2013 Federal Withholding W-4
State Withholding M-4
Direct Deposit Form

Life Insurance Beneficiary Change Form

DMS Dental Plan
Delta Dental Plans

HIPAA - 2013 Notice

Retirement Guide - Employees hired after April 1, 2012

Links
Minute Clinics
Plymouth County Retirement
Mass Teachers Retirement Board