Benefit Information - Health and Dental

SUMMARY OF BENEFITS

AFSCME
TEAMSTER
Town of Milford - Non Union

HEALTH AND DENTAL RATE SHEETS

2020

Health Insurance Rate Sheet 2020 - Town Non-Union, AFSCME and Teamster's / Opt Out Health Rate Sheet

Dental Insurance Rate Sheet 2020 - Town Non-Union, AFSCME and Teamster's / Opt out Dental Rate Sheet

2020 Insurance Rate Increase Letter - Teamster

 

2021

2021 Health Insurance Rate Sheet - Town Non-Union, AFSCME & Teamster's / Opt Out Health Rate Sheet

2021 Dental Insurance Rate Sheet - Town Non-Union, AFSCME & Teamster's / Opt Out Dental Rate Sheet

2021 Insurance Rate Increase Letter - Teamster

MEDICAL - TOWN NON-UNION AND AFSCME

HealthTrust

25 Triangle Park Drive

Concord, NH  03301

Toll free 800-527-5001

www.healthtrustnh.org

 

PO Box 617

Concord, NH  03302-0617

Type of Plan / Links

 

About Health Trust (30 min video)

 

Application

Application use this application if signing up for HealthTrust Medical AND Dental Dental

        Helpful hints for completing the application

Benefit Comparison

Medical Plan

 

 

 

 

 

Plan Documents

ACCESS BLUE NEW ENGLAND - 

AB 15/40 IPDED(01L)-R10/25/40M10/40/70/5K(L)

 

  • Group Number 362223M010 (new number for Active/COBRA)
  • Group Number 362223M011 (new number for Under 65 Retirees)

Cost Sharing Schedule

Summary of Benefits and Coverage

Subscriber Certificate

Rx Benefit Summary

Medical Plan

 

 

 

 

 

Plan Documents

ACCESS BLUE NEW ENGLAND

ABSOS25/50/3KDED(01L)-R10/25/40M10/40/70/5K(L)

 

  • Group Number 362223M014 (new number for Active/COBRA)
  • Group Number 362223M015 (new number for Under 65 Retirees)

Cost Sharing Schedule

Summary of Benefits and Coverage

Subscriber Certificate

Rx Benefit Summary

WaiverWAIVER Form - Health and Dental - Town and AFSCME
Vision Anthem Vision Discounts
EAP

Employee Assistance Program - LifeResources - EAP

To contact the LifeResources - Employee Assistance Program call 800.759.8122.

HealthTrust Submission TimeframesSubmission Timeframes
Program Materials

Benefit Education Packets Active 10.23.2020

Benefit Education Packets Retirees 10.27.2020

HealthTrust Benefit Overview

Primary Care Provider List 2020Anthem Participating Primary Care Provider List
OtherNotice of Privacy Practices

FLEXIBLE SPENDING ACCOUNT (FSA)

FSA

Flexible Spending Account

FSA Enrollment Form - fillable

FSA Plan Document

FSA Brochure

FSA Claim Form

FSA Election Worksheet

FSA Healthcare Eligible Expenses

 

*** Due to the CARES Act, You can now use your medical expense reimbursement card to pay for Over the Counter medications ( without prescriptions) such as pain relief, acid controllers, allergy, cough cold & flu, feminine hygiene products, Sunscreen 30 SPF or higher.. ect These are retroactive to January 1, 2020 for expenses incurred.  Please see attached sheet from Health Trust  for a list of eligible over the counter items!

 

Grace Period - Last day of the Grace Period:  Fifteenth day of the 3rd month following end of the play year. (3/15/xx)  Claims submitted from 1/1 - 3/15 for a prior year should be submitted manually (fax, scan, etc.).

DENTAL - ALL EMPLOYEES

Delta Dental

One Delta Drive

PO Box 2002

Concord, NH  03302

Toll free 800-537-1715

www.nedelta.com/Home

Type of Plan
ApplicationDENTAL ONLY Application - If Teamster or only taking Dental insurance through the Town (if opting out of the Town's Health Insurance)
Dental Plans

Outline of Benefits - High Option 1O FLX - 3116-5486

 

Outline of Benefits - Low Option 4 FLX - 3116 - 5490

Plan Documents

Dental Plan Document

Dental Plan Description 

Dental FAQ's

Vision

Delta Dental EyeMed Discount - Vision Care Discount

WaiverSee "Waiver Form - Health and Dental - Town and AFSCME"

MEDICAL - TEAMSTER'S

Allegiant Care

51 Goffstown Road

Manchester, NH  03102

Toll free 800-258-9732

www.myallegiantcare.com

 

 

PO Box 4604

Manchester, NH 03108

Type of Plan

Plan ID Number 02-6015031

Open Enrollment   10/26/2020 - 11/16/2020

Letter from AllegiantCare

Flyer 2021 Open Enrollment All Employers

Union DuesEff 06.2021 - Union Dues Correction
Plan Documents

2021 Teamster SBC Anthem

2020 Teamster SBC Allegiant Care (fka NNEBT) - Pkg 063

Medical Plan

Allegiant Care (fka NNEBT):

Pkg 063 = PPO 1 w/Anthem EAP,

w/AIM - NDK

Summary of Benefits

Teamster Milford Mini-Packet 2021

AllegiantCare New Hire Forms (individual)

Application (Teamster Medical Application ONLY)

Life Insurance Beneficiary

Health Insurance Census Card - Teamster

 

Application "Packet" - all 3 forms - 1 file

Waive Insurance (Opt Out)

Health Insurance Waiver - Teamster

Other Forms, etc.

2020 COVID BCP Statement

Address Change Form