Open enrollment is Thursday, April 13– Friday, May 12, 2023. 

Open enrollment is a window during which employees may add or drop their health insurance or make changes to their coverage. Open enrollment is the only time that employees can sign up for or make changes to their coverage unless you experience a qualifying event.

No open enrollment forms will be accepted after May 12^th.

Open Enrollment Forms:

 Health Care Options

• MMHG - Plan Comparison (BCBS vs. Harvard Pilgrim)
• Network Blue NE HMO Benchmark  Enrollment Form
• Harvard Pilgrim Healthcare (HPHC) HMO Choicenet Benchmark Enrollment Form
• MMHG: Acceptance/Waiver of Healthcare Benefits Form

• Aflac 
  • MA - Accident Insurance Application
  • MA - Cancer Application
  • MA - Disability Application
  • MA - Hospitalization Application
• Altus Dental 
  • Altus Dental Enrollment
• Boston Mutual
  • Boston Mutual Beneficiary Change Form
    This form should be reviewed and updated annually.
  • Boston Mutual Group Benefits Enrollment Form
• Cafeteria Plan Advisors
  Open Enrollment for the flexible spending benefit offering is in November, 2022. You may only enroll during this period if you have experienced a qualifying event.
  • CPA - Flexible Spending Benefits Plan FAQ
  • CPA New Hire-Change in Status form - Flexible Spending Pre-Tax Payroll Reduction
  • FSA Mobile App Flyer
• Colonial Insurance
  • Colonial Life Benefits Fact Sheet - 2020
  • Colonial Life - Call Center Enrollment Info - 2020
• Empower Retirement 
  Massachusetts Deferred Compensation Smart Plan - 457(b) Plan 
  • Smart Plan Enrollment Form (#98966-01)
  • SMART - Two Paths (Literature)
  • SMART Plan Overview 2020
• EyeMed
  • EyeMed Application
  • EyeMed Mobile App Flyer
• Nationwide - 457(b) Plan
  • Contact Human Resources for information
• Plymouth County Retirement
  • PCR Beneficiary Designation Form
• Security Benefit Plan Advisors 
  Saving for Retirement SFR^® 457(b) Plan
  • SFR^® Fact Sheet
  • SFR^®Enrollment Booklet
  • Participant Enrollment Form
  • Incoming Funds Request Form
    Use this form to transfer funds from another account

Please contact the Human Resources office to learn about your submission options.