Retired Employees (Senior Plans)

Open Enrollment for Medicare Eligible retirees runs until Wednesday, November 18, 2015.  

The Benefits Fair will be held on Thursday, November 12, 2015 from 10:00 am to 12:00 pm in the Selectmen’s Meeting Room, Town Hall.  This gives you and your family members or advisors the opportunity to meet with representatives from the insurance companies. You can ask questions, get explanations of the benefits, and compare differences between the Senior plans.  The representatives are there to help you make an informed decision on which plan best meets your needs.  

What Changes Are Effective On January 1, 2016?
  1. Rates are changing for all Senior plans.  A copy of the new rate schedule can be found below. 
  2. Harvard Pilgrim Medicare Enhance (HPME):  Aetna has acquired Coventry (First Health), HPME’s Prescription Benefits Manager (PBM) for retail and mail order prescription drugs.  There will be no change to the copay structure or formulary because of this acquisition, however; new Pharmacy ID cards will be issued to everyone in the plan.  The first communication to current members will be from Aetna, and it will be mailed in early November.  Pharmacy ID cards with an explanatory letter will be mailed a few weeks later.
  3. Fallon Senior
    Inpatient hospital co-pay:  from $0 to $125 per hospital stay
    Emergency Room copay:  from $50 to $75
    Retail R(x) copays:  from $10/$25/$50 to $10/$30/$65
    Mail Order R(x) copays:  from $20/$50/$100 to $20/$60/$162.50
    Skilled Nursing Facility copay:  from $0 to $25/day for the first 5 days

 Plan comparison charts can also be found below.  

What Do You Need To Do?
  1. If you are enrolling in a new plan you need to complete an insurance company application and a Payroll Agreement, and provide a photocopy of your Medicare Part A & B card for the insurance company.   
  2. If you are voluntarily cancelling your health insurance through the Town and will be receiving your coverage elsewhere you must complete an insurance company cancellation form to end your Town sponsored coverage.  
  3. If you are not making any changes at all you do not need to do anything.   
If you are not planning to attend the Benefits Fair but will be making a change please contact me to obtain all of the necessary forms.  

All forms and documents must be returned to me, Christine Fowler, in the Treasurer’s Office, by no later than Wednesday November 18, 2015.     

**** If you are not making any changes you do not need to do anything. ****