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FY 2023 Open Enrollment/Benefits Fair Information - May 2022

FY 2023 Open Enrollment/Benefits Fair Information

Open Enrollment Period: April 11, 2022 through May 13, 2022

Benefits Effective Date: July 1, 2022

Please note there is one major change in benefit providers. Our vision plan is now with Blue 20/20 instead of VSP. We are still with BCBS/MIIA, Dental Blue and TASC.

Please email, mail or drop off at the Superintendent's Office any forms you need to complete by May 13, 2022. They can be submitted to the Town Treasurer's Office or the School's Business Office. The contact information is listed on Ms. Marlborough's letter.

FY 2023 Open Enrollment-Benefits Fair Information including Blue 20/20 Vision Application and FY 2023 Medical & Dental Rates

FY 2023 Medical and Dental Rate Sheets ONLY

Blue 2020 Vision Information and Application ONLY

Health Insurance Coverage Information:

BCBS Application

BCBS HMO Blue Select Information

BCBS HMO Blue Select Information - Outside Reliant Doctors

BCBS Elect Information - Out of State

If you want to receive the annual stipend for opting out of Millbury's health insurance, please complete the enclosed form:

Health Insurance Opt Out Application

Dental Insurance Coverage Information:

BCBS Dental Blue Freedom Information - High Plan

BCBS Dental Blue Freedom Information - Low Plan

TASC Flexible Spending Account (FSA) Information:

FY 2023 TASC Flexible Spending Account Application

FY 2023 TASC Flexible Spending Account Back-up Information

The FSA Application must be filled out each year.