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Health Insurance Plan Options
Please be advised that changes to your benefits can only be made during the first 30 days after a life 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.
FY20 Health Insurance Rates
FY21 Health Insurance Rates
Plan Comparison Documents & Pre-Tax Plan Savings Options
| Benchmark Plan comparison (FSA/HRA eligible) | High Deductible Health Plan (HSA eligible) |
|---|---|
| FY20 Benchmark Plan Comparison Chart | FY20 HDHP Comparison Chart |
| FY21 Benchmark Plan Comparison Chart | FY21 HDHP Comparison Chart |
| Flexible Spending Account (FSA) Information | Health Savings Account (HSA) Information |
| Health Reimbursement Account (HRA) Info | HSA Qualified High Deductible Health Plan Video |
*Transition of Care Application - eligible applicants are defined as those who are actively undergoing treatment for a serious, life threatening medical condition whose primary specialist is not covered in the Fallon Network.
**Health Insurance Opt Out Application - to be eligible for the Health Insurance opt out option, employees must have had a Town of Wellesley health insurance plan for two consecutive years prior to opting out.
Benchmark (low deductible) manual open enrollment packet
HSA eligible (high deductible) manual open enrollment packet
Fallon Select Care - www.fchp.org
| Fallon Benchmark Plan (FSA/HRA eligible) | Fallon High Deductible Health Plan (HSA eligible) |
|---|---|
| Fallon Select Comparison Chart | Fallon Select Comparison Chart |
| Fallon Health Benchmark Plan Summary | Fallon Health High Deductible Plan Summary |
| Fallon Select Benchmark Plan Summary | Fallon Select HDHP Plan Summary |
| Fallon Select Participating Hospitals | Fallon Select Participating Hospitals |
| Fallon ID Card Mobile App | Fallon ID Card Mobile App |
| CVS Extra Care Card Savings | CVS Extra Care Card Savings |
| Naturally Well Alternative Health Care | Naturally Well Alternative Health Care |
| Right Care, Right Place, Right Time | Right Care, Right Place, Right Time |
| It Fits Reimbursement | It Fits Reimbursement |
| Fallon SC Benchmark Enrollment Form | Fallon Select HDHP Enrollment Form |
| CanRx Program - click the Fallon button at the top of the page | Fallon Health Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Fallon Prescription Formulary | Fallon Prescription Formulary |
| Good Health Gateway Diabetes Program |
Fallon Direct Care - www.fchp.org
| Fallon Benchmark Plan (FSA/HRA eligible) | Fallon High Deductible Health Plan (HSA eligible) |
|---|---|
| Fallon Health Benchmark Plan Summary | Fallon Health High Deductible Plan Summary |
| Fallon Direct Benchmark Plan Summary | Fallon Direct HDHP Plan Summary |
| Fallon Direct Participating Hospitals | Fallon Direct Participating Hospitals |
| Fallon ID Card Mobile App | Fallon ID Card Mobile App |
| CVS Extra Care Card Savings | CVS Extra Care Card Savings |
| Naturally Well Alternative Health Care | Naturally Well Alternative Health Care |
| Right Care, Right Place, Right Time | Right Care, Right Place, Right Time |
| It Fits Reimbursement | It Fits Reimbursement |
| Fallon DC Benchmark Enrollment Form | Fallon Direct HDHP Enrollment Form |
| CanRx Program - click the Fallon button at the top of the page | Fallon Health Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Fallon Prescription Formulary | Fallon Prescription Formulary |
| Good Health Gateway Diabetes Program |
Harvard Pilgrim Health Care (HPHC HMO) - www.harvardpilgrim.org
| HPHC Benchmark Plan (FSA/HRA eligible) | HPHC High Deductible Health Plan (HSA eligible) |
|---|---|
| HPHC Benchmark Plan Summary | HPHC High Deductible Plan Summary |
| HPHC Benchmark Enrollment Form | HPHC HDHP Enrollment Form |
| CanRx Program - click the HP button at the top of the page | HPHC Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
| HPHC Hospital Tier Listing |
Tufts Health Plan - www.tuftshealthplan.com
| Tufts Benchmark Plan (FSA/HRA eligible) | Tufts High Deductible Health Plan (HSA eligible) |
|---|---|
| Tufts Benchmark Plan Summary | Tufts HDHP Plan Summary |
| Tufts Benchmark Enrollment Form | Tufts HDHP Enrollment Form |
| CanRx Program - click the Tufts button at the top of the page | Tufts Health Plan Preventative Drug List - medications at co-pay level (deductible does not apply) |
| Tufts Prescription Formulary | Tufts Prescription Formulary |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
Blue Cross Blue Shield (BCBS) - www.home.bluecrossma.com
| BCBS Benchmark Plan (FSA/HRA eligible) | BCBS High Deductible Health Plan (HSA eligible) |
|---|---|
| BCBS Benchmark Plan Summary | BCBS High Deductible Plan Summary |
| BCBS Benchmark Enrollment Form | BCBS HDHP Enrollment Form |
| CanRx Program - click the BCBS button at the top of the page | BCBS Preventative Drug List - medications at co-pay level (deductible does not apply) |
| $9 Generic Drug List | |
| Blue Cross Prescription Formulary | Blue Cross Prescription Formulary |
| Good Health Gateway Diabetes Program | Good Health Gateway Diabetes Program |
Harvard Pilgrim PPO (HPHC PPO) - www.harvardpilgrim.org
| HPHC PPO Enrollment Form | HPHC PPO Plan Summary |