OPEN ENROLLMENT will be held during the month of May 

The effective date for new enrollments and changes will be July 1, 2022.

Eligibility

Benefit eligible employees are active, full time employees that are scheduled to work 20 hours or more per week.

Effective Dates & Enrollment Deadlines 

New Hires: benefits selected will be effective as of the first date of employment; enrollment information must be received in HR within 30 calendar days of hire date

Position changes (non-benefit eligible to benefit eligible): benefits will be effective the first date of the new position, enrollment information must be received in HR within 30 calendar days of the new position 

Position changes (benefit eligible to non-benefit eligible): benefits will be terminated 30 calendar days from the effective date of the new position

Eligible participants: able to enroll or make policy changes during annual open enrollment or within 30 calendar days of a qualifying event

•           Annual Open Enrollment is held during the month of May. All forms and documents must be submitted by the last business day in May. Changes become effective on July 1st.
•         Annual Open Enrollment for flexible spending accounts is held during the month of November. 
•           Click here for a list of qualifying events. All forms and required documents must be submitted within 30 calendar days of the qualifying event. Click here for types of documents required.

Enrollment Procedure

All forms can be found within the specific topics below. Please print, sign, and date forms prior to sending.

Unless directed otherwise, please send forms to Theresa Sears at Central Office. * DO NOT EMAIL.

Options are: Fax 508-746-1873, Interoffice or US mail. 

ACTIVE EMPLOYEES

Enrollment Form

        FY23 Health Rates

         Blue Care Elect 

           Blue Choice

           *Comparison of the Under 65 plans 

RETIREES

           Managed Blue for Seniors

           MEDEX

Enrollment Form

Enrollment Form w/Editable Fields (to allow you to fill in online) FOR RETIREES

Rates for FY23

BCBS Dental Freedom - Summary of Benefits

FY23 Dental

Dental Enrollment Form

Aflac 

Call Jeff Nelson (774)254-4328 to enroll or request additional information 

•       Accident Insurance 
  
  • cash paid directly to you
  • family coverage is available
•       Short-Term Disability
  
  • customized plans 
  • maternity leave included after 10 months of being on a policy
•       Cancer Insurance
  • policies pay a first occurrence benefit of up to $12,000 to help with immediate costs
  • policies continue to pay over the course of treatment

Open enrollment flyer

Enrollment form

Boston Mutual* 

Call Peter Cook (781) 837-9222 or email Peter@LPINS.com for additional information.

•       Basic & Voluntary Life Insurance Rates
•       Life Insurance Enrollment Form
•       Life Insurance Change of Beneficiary Form
•       Long Term Disability Benefit Summary
•       Long Term Disability Enrollment Form             

Mass Mutual*

Call Mike Rothberg (508)584-4044 for additional information

•       Permanent Life Insurance

*Guaranteed issue for Boston Mutual and Mass Mutual is upon being hired or being moved into a benefit eligible position. Enrollment must be done with 30 calendar days.

You may apply for these during annual open enrollment, but enrollment is not a guarantee. 

If you get hurt at/during work, please notify your school nurse to complete a work injury report.

Please notify Theresa Sears if you work at central office or the facilities office.

MIIA Contact Information

Brianne Crook

One Federal Street

Boston, MA 02110-2012

Phone: (617)457-7643

Fax: (847)953-4466

Brianne.Crook@aon.com

Employee Assistance Program

Weight-Loss Reimbursement

Fitness Reimbursement

               BJs Instructions

               Enrollment or Renewal form

BJs "Special Offer"

Bj’s has stopped the year round renewal and is limiting it to the month of our annual open enrollment. Please see the attached information and pricing. This year we are also using BJ’s as a fund raiser for the district. Please see below for more information on that –

 BJ's Wholesale Club will donate $5 (or $10 if Rewards) to the PLYMOUTH PUBLIC SCHOOLS for every membership which is newly opened or extended. 

 The forms and payments must be mailed directly to my attention at the address in the mailing instructions and also below by the postmark deadline of May 31, 2022. The form and payment may not be returned to any BJ’s Club location. The forms will be tallied and the Check Request Form will be forwarded to my Home Office for processing based upon the number of forms collected.  Your check will arrive within six weeks. Please keep in mind that applications postmarked after May 31^st will not be processed under the Club For A Cause program.  

 The pricing structure for this event is as follows:

 Any employee or supporter may OPEN a NEW Rewards membership at the discounted rate of $50/12 months ($60 savings off the In-Club rate of $110/12 months) or may OPEN a NEW Inner Circle membership at the discounted rate of $25/12 months ($30 savings off the In-Club rate of $55/12 months). This applies to NEW members only…previous or existing members are not eligible.

 This program also enables your employees to EXTEND their existing Rewards or Inner Circle memberships at the following rates:

 The Rewards renewals will be $110/12 months with $30 being loaded back to their card.  They will have $30 in awards waiting for them at the Club once processed.

 The Inner Circle renewals will be $55/12 months with $20 being loaded back to the card.  They will have $20 in awards waiting for them to spend at the Club once processed.

 With payment, 12 months will be ADDED onto to the current expiration date of existing members. 

 Any employee whose membership is due to expire between now and your next open enrollment event (May 2022) is encouraged to take advantage of this special offer.  Renewing members insert their membership number at the top of the enrollment form and, with payment, their membership will be extended for 12 months beyond whatever their current expiration date happens to be. Trial Memberships and Business Memberships (indicated by a 5 or 8 in the fourth position of the membership number) are not eligible for renewal under this program. 

                 Plymouth Club for a Cause Flyer

                        I

403(b) Retirement Savings

        2021 Plan Summary

        Authorized Investment Providers

        Vendors known to PPS

        Security Benefits

        AXA Flyer

        Ameriprise Financial brochure

        Enrollment Form

Cafeteria Plan

            Flexible Spending Accounts - enrollment held during the month of November

Retirements

Health Plans: Managed Blue for Seniors

                    MEDEX

Dental Plan: Blue Freedom

Direct Deposit form (Medicare B Reimbursement for eligible participants)

Resignations

Benefits will be terminated 30 calendar days from your last day of employment.

COBRA information will be mailed to you from a third-party vendor within a couple weeks of your exit date.