Open enrollment occurs during the month of May and is your annual opportunity to add or change medical, dental, life and/or disability plan(s), and add or drop eligible dependents from coverage. The only other opportunity you have to make these changes is when you experience a qualifying life event such as a birth or adoption of a child, marriage, divorce, loss of coverage, etc. If you are currently enrolled in a plan listed and do not want to make any changes, you do not need to take any action.
If you choose to change any part of your coverage, you must do so during the Open Enrollment Period. You must re-enroll in the Flexible Spending Account (FSA) for the healthcare and dependent care account.
During this Open Enrollment Period You May:
- Apply for optional benefits: Life, Short Term Disability, Long Term Disability, and Cancer Insurance.
- If enrolling in Basic and/or Optional Life Insurance through Boston Mutual, you must complete the Boston Mutual enrollment form and the Boston Mutual Evidence of Insurability Form.
- If interested in enrolling in any of the optional benefits (permanent life insurance, short and/or long-term disability, or cancer insurance), contact LifePlus Insurance Agency at 781-837-9222. You must enroll in any of the above insurance plans by May 29th.
- Change medical and/or dental election tier; select from individual or family coverage.
- Please note that there is a two (2) year commitment under the Delta Dental Enhanced Program (must stay in plan for 2 full years).
- Change medical coverage, choosing between Blue Cross and Blue Shield Blue New England (HMO) and Blue Care Elect (PPO).
- Enroll or re-enroll in the Flexible Spending Account(s)
- Enroll yourself and dependent(s) in a medical and/or dental coverage
- If enrolling spouse and/or dependents, please provide proof of relationship for members expected to part of a family plan - marriage certificate and/or birth certificate(s).
- Please provide names of all dependents’ primary care providers (PCP) for the HMO plan option.
- Terminate medical and/or dental coverage for yourself and dependent(s).
- Update your address if you have recently moved.
- Update your beneficiary for your Life Insurance Policy(ies).
Please return all completed forms to Human Resources no later than May 28, 2021. Forms may be scanned and emailed (preferred) to Jody Middleton, HR Director at firstname.lastname@example.org or Meredith Hartling, HR Generalist at email@example.com; faxed to 781-575-6602; or mailed to Town of Canton Human Resources, 801 Washington Street, Canton, MA 02021. If you have any questions, comments or feedback about our benefits program, please contact HR at the emails above or call Jody at 781-821-2936 or Meredith at 339-502-5727. Thank you!
- BCBS Enrollment/Change Form
- Delta Dental Enrollment/Change Form (PDF)
- Blue Medicare RX (PDP) Enrollment Form
- Flexible Spending Account Enrollment Form (PDF)
- Basic and Optional Life Enrollment Form (PDF)
- Boston Mutual Beneficiary Change Form (PDF)
- Boston Mutual Evidence of Insurability Form (PDF)
- Address Change Form (PDF)