Health Insurance Plans
(click the links for enrollment forms / plan & Benefit overview)
- Blue Cross/Blue Shield: Blue Care Elect Preferred / No Delta Dental
- BCBS Waltham Medex3 Senior Over 65 Medicare A & B
- Harvard Enhanced Senior Over 65 Medicare A & B
- Tufts Complement Senior Over 65 Medicare A & B
- City of Waltham Benefit Comparison Chart of Medicare Plans
If you have questions related to Medicare please contact Medicare directly at www.medicare.gov/ or 1-800-633-4227.
The City's contributions to the plans are: 89% of the cost of HMO and 87.5% of the cost of Blue Cross Blue Shield. New employees may select one of these plans. An open enrollment every May provides employees with an opportunity to reselect.
The effective date of health care coverage depends on your date of hire. If date of hire is between the 1st-23rd day of the month, your insurance is effective the 1st day of the following month. Note: employees contributions are pre-paid 1 month , so payment of 4 weeks is required. If your hire date is the 24th-last day of the month, insurance coverage becomes effective five weeks from hire. July1 if the employee transfers, depending on the plan. Dependent children are eligible up to their 26th birthday.
In order to enroll a spouse and/or dependents to you health plan the City requires a copy of your marriage license and birth certificates for dependents.
In the event of a loss of health insurance, birth, marriage or divorce, it is the responsibility of the employee to notify the Payroll Department within 30 days of the event. Birth certificate, marriage certificate and/or divorce decrees will also need to be provided at this time. Failure to meet this timeline will result in waiting until the next open enrollment period.
Complete information on all health plans and enrollment forms are provided in your orientation package.
(Available with Harvard Pilgrim Health Plan HMO and Tufts Health Plan HMO only)
- Preventative dental services are covered at 100% with no deductible.
- Restorative services covered at 80% after a $50.00 per person deductible.
- Prosthodontics and Major Restorative are covered at 50%
- Braces are not covered.
There is no additional cost for the dental coverage with the Harvard Pilgrim or Tufts coverage, there is no coverage offered with Blue Cross Blue Shield. For more information on coverage, please consult the Delta Dental information included in your Orientation Package.
*If you choose not to select the Health Insurance benefit, you must complete the Waiver of Group Health Insurance Coverage Form included in your Orientation Package.
Contact information for these health plans is as follows:
- Harvard Community Health Plan: 1-888-333-4742 / TDD: 1-800-637-8257 / Mental Health: 1-888-777-4742
- Tufts Health Plan: 1-800-462-0224 / TDD: 1-800-815-8580
- Blue Cross/Blue Shield: 1-800-782-3675
- Delta Dental: 1-800-872-0500
Life Insurance Plan
The City offers full-time, permanent employees basic life insurance in the amount of $15,000. To be eligible for the Additional Optional Coverage employees must first be enrolled in the basic program. On the enrollment form, Plan A is the basic plan and Plan B is the optional plan.
Full-time, permanent employees under age 75 who desire additional coverage are entitled to purchase life and accidental death and dismemberment insurance in $5,000 denominations up to the amount of the employee's salary.
Full-time, permanent employees under the age of 75 are entitled to purchase dependent coverage. Dependent coverage includes only life insurance. Accidental death and dismemberment's not included.
In order to be eligible for dependent coverage, full-time permanent employees must first purchase at least $5,000 in additional optional coverage. The entire premium for any additional coverage is to be paid by the employee through payroll deductions.
When an employee is terminated, resigns, retires or reaches age 75, all additional coverage ends. The employee has the right to convert the full amount of additional coverage to an individual policy. When an employee under age 75 retires, he/she may take his/her additional coverage with them until age 75.
Once you have applied for life insurance you will receive an Insurance Certificate of Coverage from the City of Waltham Payroll Department by mail within 30 days of enrollment. If you do not receive this certificate please contact the Payroll Department at 781-314-3270.
For more information see your orientation package or contact the Human Resources Department.
Allstate Cancer Insurance
The City of Waltham offers full-time, permanent employees the opportunity to enroll in Allstate Cancer Insurance. Coverage may include you, your spouse and children under age 26.
Pre-Existing Condition Limitation:
We do not pay benefits for a pre-existing condition during the 12-month period beginning on the date that person’s coverage starts. A pre-existing condition is a disease or condition for which symptoms existed within the 12-month period prior to the effective date, or medical advice or treatment was recommended or received from a medical professional within the 12-month period prior to the effective date. A pre-existing condition can exist even though a diagnosis has not yet been made.
Coverage under the policy ends on the date the policy is canceled; the last day premium payments were made; the last day of active employment, unless coverage is continued due to Temporary Layoff, Leave of Absence or Family and Medical Leave of Absence; the date you or your class is no longer eligible. Spouse coverage ends upon divorce or your death. Coverage for children ends the earlier of when the child reaches age 26 or 2 years following loss of dependent status under the Internal Revenue Code, unless he or she continues to meet the requirements of an eligible dependent. Coverage may be continued under the Portability Provision when coverage under the policy ends. Refer to your Certificate of Insurance for details or contact LifePlus Insurance 781-837-9222
* See Allstate Cancer Brochure for more
COBRA (Competitive Omnibus Budget Reconciliation Act)
Cobra requires employers to offer employees and their families the opportunity to continue their group health care coverage for 18 to 36 months dependent upon the "qualifying event" that leads to the ultimate termination of coverage. If you do choose continued coverage, you have 60 days from the date you would lose coverage to inform the Human Resources Department. If you do not choose continued coverage, your group coverage will end and cannot be reinstated.