Non-Union Personnel Manual
Safety Manual
Aflac Insurance Products
Insurance open enrollment period starts October 19, 2022 for changes effective January 1, 2023. You are responsible for notifying DeAnn LeBlanc regarding the events indicated below:
- Wish to change benefit plans.
- Have changed your address or phone number.
- Have a change in marital status.
- Have begun receiving Medicare benefits for yourself or any family member.
- Wish to enroll yourself and any eligible family members.
- Wish to enroll or remove a dependent child.
Info is also available at www.healthtrustnh.org/what#medical
DPW, Library, Recreation and Town Hall employees
Benefit Election Form (must be submitted by December 1, 2023)
Flexible Benefits Enrollment Form
Insurance Application or Change Form
Children’s Health Insurance Program
Health Insurance Plan Option Information:
a. AB15IPDED(01L) RX 10/20/45 – Summary of Benefits and Coverage
b. ABSOS20/40/1KDED(01L) – RX 10/20/45 – Summary of Benefits and Coverage
c. ABSOS25/50/3KDED(01L) RX 10/20/45 – Summary of Benefits and Coverage
Dental Insurance Plan Option Information:
Police employees
Benefit Election Form (100% employee) Due by December 1, 2023
Benefit Election Form (80% employee)
Benefit Election Form (75% employee)
Benefit Election Form (60% employee)
Flexible Benefits Enrollment Form
Insurance Application or Change Form
Children’s Health Insurance Program
Health Insurance Plan Option Information:
- a. AB15IPDED(01L) RX 10/20/45 – Summary of Benefits and Coverageb. ABSOS20/40/1KDED(01L) – RX 10/20/45 – Summary of Benefits and Coveragec. ABSOS25/50/3KDED(01L) RX 10/20/45 – Summary of Benefits and Coverage
Dental Insurance Plan Option Information:
DPW, Library, Recreation and Town Hall employees
Benefit Election Form (must be submitted by December 1, 2023)
Flexible Benefits Enrollment Form
Insurance Application or Change Form
Children’s Health Insurance Program
Health Insurance Plan Option Information:
a. AB15IPDED(01L) RX 10/20/45 – Summary of Benefits and Coverage
b. ABSOS20/40/1KDED(01L) – RX 10/20/45 – Summary of Benefits and Coverage
c. ABSOS25/50/3KDED(01L) RX 10/20/45 – Summary of Benefits and Coverage
Dental Insurance Plan Option Information:
Police employees
Benefit Election Form (100% employee) Due by December 1, 2023
Benefit Election Form (80% employee)
Benefit Election Form (75% employee)
Benefit Election Form (60% employee)
Flexible Benefits Enrollment Form
Insurance Application or Change Form
Children’s Health Insurance Program
Health Insurance Plan Option Information:
- a. AB15IPDED(01L) RX 10/20/45 – Summary of Benefits and Coverageb. ABSOS20/40/1KDED(01L) – RX 10/20/45 – Summary of Benefits and Coveragec. ABSOS25/50/3KDED(01L) RX 10/20/45 – Summary of Benefits and Coverage
Dental Insurance Plan Option Information: