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 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.