Insurance

Health Insurance Plans

The City of Waltham contributes to 89% of the cost of the HMO plans and 87.5% of the Blue Cross Blue Shield Plans.  New full-time permanent employees are eligible to select one of these plans upon hiring.  Our annual open enrollment period held the first two weeks of May provides benefit eligible employees with the opportunity to change health insurance plans for coverage starting July 1^st.    

Your date of hire determines the effective date of your health insurance plan. Your insurance is effective on the 1^st of the upcoming month if your hire date is between the 1st-23rd day of the month. Note: employee’s contributions are required to be pre-paid 1 month in advance and make up payments may be required. Employees hired between the 24^th and last day of the month will have an insurance effective date 5 weeks later on the 1^st of the next month. Employees transferring may be effective July 1st depending on the plan. Dependent children are eligible until the last day of the month of their 26th birthday.

In order to enroll a spouse or dependent child to your health plan the City requires an original raised seal certified copy of the following documents if applicable: 

• Marriage Certificate
• Birth/Adoption Certificates for dependent children
• Court approved divorce decree of the employee and/or spouse including the docket number, health and life insurance sections and signature page.

It is the responsibility of the employee to notify and submit health insurance enrollment forms, termination requests and required documentation to the Payroll Department within 30 days of a qualifying life event such as a loss of health insurance, birth/adoption, marriage or divorce.  Failure to meet this timeline will result in waiting until the next open enrollment period.  You also must notify if your status has changed from family to individual.

Complete information on all health plans and enrollment forms are provided in your new hire or full-time employee benefit package.

Employees and health insurance carriers are not permitted to process enrollments or make changes directly.  An enrollment processed directly with the health insurance carrier may result in the termination of health insurance coverage from the City.
 

• Harvard Pilgrim Health Care (HMO) / Delta Dental Premier 
• Tufts Health Plan (EPO) / Delta Dental Premier
• Blue Cross/Blue Shield: Blue Care Elect Preferred (PPO) / No Delta Dental

• BCBS Waltham Medex3 Senior Over 65 Medicare A & B
• Tufts Medicare Preferred Medicare Supplement PDP Senior Over 65 Medicare A & B
• City of Waltham Benefit BCBS Medex3 and Carve Out A & B Medicare Plans

If you have questions related to Social Security or Medicare please contact those agencies directly: www.ssa.gov or find your local office by searching Social Security Office Locator or call 1-800-772-1213; www.medicare.gov/ or 1-800-633-4227

If you have questions related to health insurance please contact 781-314-3270.

Current School Employees must submit enrollment forms and required documentation to:
School Payroll
Waltham High School
617 Lexington Street
Waltham, MA 02452
schoolpayroll@city.waltham.ma.us
 

Newborn Coverage

See overview here
 

Delta Dental

(Available with Harvard Pilgrim Health Plan HMO and Tufts Health Plan PPO 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 benefit 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 benefit package.

Contact information for these health plans is as follows:

• Harvard Pilgrim Health Care: 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 dismemberments 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. Please contact the Payroll Department at 781-314-3270 if you do not receive this certificate.

For more information see your benefit package or contact the Human Resources Department.

* If you choose not to select the Life Insurance benefit, you must complete the Refusal section of the enrollment form included in your benefit package. 

Boston Mutual Life Insurance Beneficiary and Name Change Form

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.