Active Employees and Non-Medicare Retirees

Coverage Adjustments

To make a change from your existing coverage to another plan, enroll or cancel coverage for yourself or any of your dependents, or to enroll with the town as a new subscriber please complete the Insurance Company's Application/Enrollment Form, found below.

If the change you are making results in a corresponding change to your premium (new, increase or decrease) you also need to complete an Employee Payroll Agreement, found below.

Enrolling Dependents

If you are enrolling a dependent for the first time you must include: 

  • For a spouse or ex-spouse:  a copy of their Social Security Card and your city/town issued marriage certificate or your divorce decree.
  • For dependent children under age 26:  a copy of their Social Security Card and a birth certificate, adoption or guardianship papers.

Enrollment Deadlines

All applications and accompanying paperwork must be received by the Benefits Coordinator in the Town Manager's Office, within 30 days of the qualifying event.

Please contact the Benefits Coordinator at benefits@shrewsburyma.gov to determine what additional documentation is required.

Plan Information

  1. FY23 Benefit Guide
  2. FY23 Active Rates
  3. 2022-2023 Active Employee Payroll Agreement Form with Dental
  4. 2022-2023 NM Retiree-SS Payroll Agreement Form
  5. WSHG Benchmark Comparison Chart FY23
  6. WSHG HSA Comparison Chart FY23
  7. WSHG Comparison Chart FY23 Combined

Forms

  1. Health Savings Account "HSA" Information for High Deducible - Health Equity
  2. Life Insurance Enrollment Form

Insurance Company Applications

  1. Blue Cross Blue Shield (PDF)
  2. Harvard Pilgrim HMO (PDF)
  3. Harvard Pilgrim PPO (PDF)
  4. Tufts (PDF)
  5. 2022 Health Equity Payroll Deduction Form