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
PO Box 617 Concord, NH 03302-0617 | Type of Plan / Links
About Health Trust (30 min video)
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| Application | Application use this application if signing up for HealthTrust Medical AND Dental Dental Helpful hints for completing the application |
Medical Plan
Plan Documents | ACCESS BLUE NEW ENGLAND - AB 15/40 IPDED(01L)-R10/25/40M10/40/70/5K(L)
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Medical Plan
Plan Documents | ACCESS BLUE NEW ENGLAND ABSOS25/50/3KDED(01L)-R10/25/40M10/40/70/5K(L)
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| Waiver | WAIVER 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 Timeframes | Submission Timeframes |
| Program Materials | Benefit Education Packets Active 10.23.2020 Benefit Education Packets Retirees 10.27.2020 |
| Primary Care Provider List 2020 | Anthem Participating Primary Care Provider List |
| Other | Notice of Privacy Practices |
FLEXIBLE SPENDING ACCOUNT (FSA)
| FSA | Flexible Spending Account FSA Enrollment Form - fillable |
*** 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 | Type of Plan |
| Application | DENTAL 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 | |
| Vision | Delta Dental EyeMed Discount - Vision Care Discount |
| Waiver | See "Waiver Form - Health and Dental - Town and AFSCME" |
MEDICAL - TEAMSTER'S
Allegiant Care 51 Goffstown Road Manchester, NH 03102 Toll free 800-258-9732
PO Box 4604 Manchester, NH 03108 | Type of Plan Plan ID Number 02-6015031 |
| Open Enrollment 10/26/2020 - 11/16/2020 | |
| Union Dues | Eff 06.2021 - Union Dues Correction |
| Plan Documents | 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 | |
| AllegiantCare New Hire Forms (individual) | Application (Teamster Medical Application ONLY) Health Insurance Census Card - Teamster
Application "Packet" - all 3 forms - 1 file |
| Waive Insurance (Opt Out) | |
| Other Forms, etc. |