Lincoln-Sudbury RegionalHigh School

Employee Benefits 07/01/2024 - 06/30/2025

LS Employee Benefits Guide

HARVARD PILGRIM HEALTH CARE (3 Plans):

HMO with HSA
*HMO with HSA Summary of Benefits and Coverage 
*HMO with HSA Schedule of Benefits 
*HMO with HSA Prescription Coverage

Focus Network MA HMO
*Focus Network MA HMO Flyer 
*Focus Network MA HMO Summary of Benefits and Coverage
*Focus Network MA HMO Schedule of Benefits
*Focus Network MA HMO Prescription Coverage

HMO
*HMO Summary of Benefits and Coverage 
*HMO Schedule of Benefits 
*HMO Prescription Coverage

Harvard Pilgrim Insurance Rates and Enrollment Form:
*Medical Plan Rate Contribution 07/01/2024 - 06/30/2025
*Harvard Pilgrim Enrollment Form 

Disclosure Notice:
*Medicare Part D Creditable Coverage Disclosure Notice 

ALTUS DENTAL:
*Altus Dental Benefits Summary Low Plan 
*Altus Dental Benefits Summary High Plan 
*Altus Preventive Rewards Flyer 
*Altus Dental PreTreatment
*Altus Web Flyer
*Altus Dental Enrollment Form 

ALTUS VISION:
*Altus Vision Benefit Summary V150Plus 
*TruHearing Hearing Aid Discount Offer (Member) 
*VSP Diabetic Eyecare Plus Program 
*VSP Network 
*Altus Vision Enrollment Form 

CAFETERIA PLAN ADVISORS - FLEXIBLE SPENDING (FSA):
*FSA Store 
*FSA Cafeteria Plan Advisors Flyer 
*FSA Cafeteria Plan Advisors WEX Health Payment Card Benny for FSA & Commuter Benefits 
*FSA Cafeteria Plan Advisors Enrollment Form 
*OTC New Expenses Now Eligible 

HEALTHEQUITY (HSA):
*HSA Store 
*HSA Introduction 
*HSA Payroll Deduction Form 

403(b):
403(b) plan (tax-sheltered annuity plan or TSA) is a retirement plan.
Link to 403b Providers TSA Consulting Group: LS 403b Providers through TSA Consulting Group 

*403(b) Plan Participation Guide 
*403(b) Meaningful Notice - Plan Summary 2025 
*403(b) Annual Retirement Benefits Guide 2025
*403(b) Enrollment Form 
*403(b) Distribution Information 
*IRS Notice 2023-62

457:
The Massachusetts Deferred Compensation 457 SMART Plan is a retirement savings program available for Commonwealth of Massachusetts state and municipal employees. Eligible employees can save and invest before-tax and after-tax dollars through salary deferrals into our wide array of low fee investments options.
*457 Smart Plan
*457 Territory Map for Representative contacts