Medical Insurance
Please be advised that changes to your benefits can only be made during the first 30 days after a qualifying event (birth, death, adoption, marriage, divorce, etc.) or during open enrollment. Newly hired benefit eligible employees have 30 days from their start date to make benefit selections.
| Benchmark Plan comparison (FSA/HRA eligible) | High Deductible Health Plan (HSA eligible) |
|---|---|
| FY26 Benchmark Plan Comparison Chart | FY26 HDHP Comparison Chart |
| Health Reimbursement Account (HRA) Info | Health Savings Account (HSA) Information |
| Flexible Spending Account (FSA) Information |
Blue Cross Blue Shield (BCBS)
Network coverage area includes MA, RI, CT, NH, ME & VT
Member Service #: 800-782-3675 Customer Service #: 800-262-2583
| BCBS Benchmark Plan (FSA/HRA eligible) Network Blue® $300 Deductible with HCCS Group Number 00-4053588 | BCBS High Deductible Health Plan (HSA eligible) Access Blue New England Saver Group Number 00-4062729 |
|---|---|
| BCBS Benchmark Enrollment Form | BCBS HDHP Enrollment Form |
| BCBS Benchmark Summary of Benefits and Coverage | BCBS High Deductible Summary of Benefits and Coverage |
| BCBS Benchmark Plan Summary | BCBS High Deductible Plan Summary |
| Benefit Description | Benefit Description BCBS Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Find a Doctor* Tool requires Dr. name, zip code and Network Plan Name = Network Blue New England Deductible HMO Network = HMO Blue New England Network with Hospital Choice Cost Sharing Feature | Find a Doctor* Tool requires Dr. name, zip code and Network Plan Name = Access Blue New England Saver Network = HMO Blue New England |
*When searching the BCBS website for a doctor, be sure to use all the credentials 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 with your doctor search.
Limited Network Plans (BCBS)
Network coverage area includes MA ONLY**
**Before selecting this plan, be sure your doctors are covered by using the "Find a Doctor" tool with the credentials specified below
| BCBS Benchmark Select Plan (FSA/HRA eligible) Network Blue® Select $300 Deductible with HCCS Group Number 00-4069885 | BCBS High Deductible Select Health Plan (HSA eligible) Network Blue® Select Saver Group Number 00-4070369 |
|---|---|
| BCBS Benchmark Select Enrollment Form | BCBS HDHP Select Enrollment Form |
| BCBS Benchmark Select Summary of Benefits and Coverage | BCBS 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 Member Service #: 800-782-3675 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 Member Service #: 800-782-3675 Customer Service #: 800-262-2583 |
*When searching the BCBS website for a doctor, be sure to use all the credentials 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 with your doctor search.
All BCBS Plans Include:
Harvard Pilgrim Health Care (HPHC)
Network coverage area includes MA, RI, CT, NH, ME & VT
PPO network is nationwide
Customer Service: 888-333-4742
| HPHC Benchmark Plan (FSA/HRA eligible) The Harvard Pilgrim Best Buy ChoiceNet HMO Group Number 028848-0030 | HPHC High Deductible Health Plan (HSA eligible) The Harvard Pilgrim Best Buy HSA HMO Group Number 018992-0018 | HPHC PPO Group Number 033318-0010 |
|---|---|---|
| HPHC Benchmark Enrollment Form | HPHC HDHP Enrollment Form | |
| HPHC Benchmark Summary of Benefits and Coverage HPHC Benchmark Schedule of Benefits HPHC Medical Coverage and Cost Sharing (benchmark) | HPHC High Deductible Summary of Benefits and Coverage HPHC High Deductible Schedule of Benefits HPHC Preventative Drug List - medications at co-pay level (deductible does not apply) HPHC Medical Coverage and Cost Sharing (HD) | HPHC PPO Summary of Benefits and Coverage HPHC PPO Schedule of Benefits HPHC Medical Coverage and Cost Sharing (PPO) |
| Find a Doctor - HPHC Plan Type = HMO Plan Category = Tiered/Limited Plans Tiered/Limited Plans = ChoiceNet HMO Click to enlarge: | Find a Doctor - HPHC Plan Type = HMO Plan Category = Standard Plans Standard Plans = HMO or HMO Open Access Click to enlarge: | Find a Doctor - HPHC Plan Type = PPO Plan Category = Standard Plans Standard Plans = PPO Click to enlarge: |
All HPHC Plans Include:
ALL OF OUR MEDICAL PLANS INCLUDE:
Save on Diabetes Medication
Prescription Drug Savings
FREE Delivery of All Medications & Supplies
Proactive REFILL Calls & Care Coordination
Administration Options & Infusion Services
OPT OUT BENEFIT
*Medical Insurance Opt Out Application- to be eligible for the Medical Insurance opt out option, employees must have had a Town of Wellesley medical insurance plan for two consecutive years prior to opting out.
PLEASE NOTE: This form will be processed only with an email to benefits@wellesleyma.gov indicating you are dropping your medical insurance and when. Submitting the form on its own is not sufficient to stop coverage or deductions when it comes to opting out of medical insurance. If you have previously filled out an opt out form and are currently receiving an opt out payment, you do not need to fill out another opt out form to continue to be eligible for the opt out payment.
If you dis-enroll from a town medical insurance plan, any free additional insurance coverage provided will revert to a paid coverage option the day after the town health insurance plan is dropped.