Open Enrollment

To Submit Open Enrollment Documents Securely, please Click Here. 

We are very excited to announce that Town of Belmont Open Enrollment will begin on Monday, April 22, 2024 and will end Friday, May 13, 2024! This open enrollment is for Non-Medicare Retirees seeking to change their health insurance or dental insurance must do so during this time frame.  All changes are effective July 1, 2024. 

***If you do not wish to make a change to your health or dental plan, then you do not need to contact our offices or complete any forms.  Your current plans and coverage will remain in effect.***

Annual Benefits Fair:

We are happy to announce there will be an Annual Benefits Fair on Monday April 22, 2024 from 2:00pm to 5:00pm at the Belmont Art Gallery on the top floor of the Homer Municipal Building (19 Moore St).Town Human Resources Staff will be available on April 22, 2024 to answer questions and accept applications for dental and health insurance changes. Representatives from various benefit providers will also be in attendance to answer your questions. 

Updates:

1. Health insurance, provided through Harvard Pilgrim, will increase on July 1, 2024 by 4% for both the Harvard Pilgrim PPO and the Harvard Pilgrim HMO.
2. Delta Dental rates will remain the same for fiscal year 2025.  The Town will continue to offer two Delta Dental plans, the Delta Dental Premier Voluntary and the Delta Dental PPO Plus Premier Voluntary Enhanced.

Plan Information

Plan Summaries

FY25 Health Plan Rates

FY25 Dental Plan Rates

Enrollment Forms

Harvard Pilgrim Enrollment Form

Delta Dental Enrollment Form

Supporting Documentation:

Whether you are applying for a Family Dental or Health Plan you should expect to submit the following supporting documentation. 

• To add a Spouse, please include a copy of your marriage license/certificate. 
• To add other dependents (i.e. children), please include a copy of each dependents Birth Certificate

To Cancel Coverage:

To terminate your coverage, please submit a signed enrollment/change form with the appropriate "Terminate Contract" box selected. In addition, we ask that you provide a "proof of coverage" documentation from your new insurance provider. 

Submission:

Please DO NOT EMAIL ENROLLMENT FORMS AS ATTACHMENTS, as they contain sensitive information such as social security numbers and birth dates. Forms can be dropped off at the Town Human Resources Office (Belmont Town Hall 455 Concord Avenue, 2^nd Floor) or submitted electronically by using the secure link below.

Please Click Here to upload documents securely. 

You will need to enter your name, email and department prior to uploading and we kindly ask that after you upload the file to send an email to mcarolan@belmont-ma.gov to confirm that the documents have been received.