Acton-Boxborough Regional School District

Developing engaged, well-balanced learners through collaborative, caring relationships

• WELLNESS
• EQUITY
• ENGAGEMENT

Health Benefits Rates 

• FY24 Health and Dental Insurance Rates

Health Plan Enrollment Forms

• Blue Cross Blue Shield Enrollment Form
• HPHC Enrollment Form

FY24 Flexible Spending Accounts (FSA)

Our FSA plan runs from July 1, 2023 thru June 30, 2024. Open enrollment runs from April 1 thru May 26, 2023.  You may sign up for a Health Care and/or a Dependent Care Account.

• The maximum amount you can put away for your Health Care Account is  $3,050. The Dependent Care Maximum is $5,000 per household.
• You must enroll and fill out new paperwork each year; the FSA does not renew automatically. Existing participants can re-new online here. New Enrollees must complete the FSA Enrollment form below and submit to Cafeteria Plan Advisors.
• You can use your FSA Health Care funds to pay for health insurance deductibles and co-pays with our low deductible HMO plans. 
• You can have a Dependent Care Account regardless of your health insurance plan.
• You can not have an FSA Health Care account if you are opening an HSA (Health Savings Account).

• Flexible Spending Information
• Flexible Spending Enrollment Form
• Health Care Eligible Expenses
• Dependent Care Form
• Prepaid Benefits Card

Health Savings Account (HSA) Information

• HealthEquity Website
• Blue Cross Member Portal
• Harvard Pilgrim Member Portal
• Beneficiary Form
• Electronic Funds Transfer Form
• HealthEquity Payroll Deduction Form FY22

FY24 Investment Opportunities

• 403(b) Plan Information
• 403(b) Vendor List
• 403(b) Plan Highlights
• TSA Transaction Information Form
• TSA Salary Reduction Form
• TSA Online Salary Reduction Agreement System
• Plan Overview
• 457 Plans—Contributing Through Two Plans

FY24 Insurance Benefits

• Voluntary Life Insurance
• Cancer Expense Brochure
• Cancer Expense Rate Sheet
• Accident Insurance Brochure
• Universal Life Insurance Brochure
• Disability Insurance Brochure

FY23 Benefit Summaries

• BCBS Blue Care Elect PPO Benefits & Coverage
• BCBS Blue Care Elect PPO Summary of Benefits
• BCBS Access Blue (High Ded w/HSA) Benefits & Coverage
• BCBS Access Blue (High Ded w/HSA) Benefits Summary
• BCBS Network Blue HMO 250/750 Benefits & Coverage
• BCBS Network Blue HMO 250/750 Benefits Summary
• HPHC High Ded. w/HSA Plan Information
• HPHC 250/750 Plan Information
• HPHC Cost Estimator Information

Benefit Comparison

• FY23 Health Plan Comparisons

Altus Dental Coverage

• Altus Dental Plan Summary - Low Plan
• Altus Dental Plan Summary - High Plan
• Altus Dental Maximum Carryover Flyer
• Altus Two-tier Dental Enrollment Form

EyeMed Vision Coverage

• EyeMed Benefit Summary
• EyeMed Enrollment Form

Employee Assistance

• MIIA Employee Assistance Program