Early Retirees and Non-Medicare Eligible Retirees

Early Retirees and Non-Medicare Eligible Retirees


**Enrollment forms need to be received by Friday, May 6, 2022


Summary of Benefits – HMO
Summary of Benefits – HMO with HSA (high deductible plan)
Summary of Benefits – PPO (option only if you live outside of MA)
2022 Medicare Part D Notice

Early Retiree Rate Contribution 2022-23

2022-23 Retiree HMO Enrollment Form
2022-23 Retiree High Deductible HMO Enrollment Form
2022-23 Retire PPO Enrollment Form


SmartStart Flyer – Ask Questions of a HP Representative before our plan effective date 6/1/21
MyHealthMath Flyer – Get cost information to assist in deciding on which plan is best for you

Altus Dental – Summary of Benefits LOW Plan
Altus Dental – Summary of Benefits HIGH Plan
Altus Dental – Enrollment Form (*For new members that have not had dental coverage
previously with the district or changing plan type only)