Eligibility
 

Your Tufts Health Plan Benefits: Eligibility and Plan Participation

PLAN ELIGIBILITY PLAN PARTICIPATION

Medical Plans:

  • Your Choice
    Exclusive Provider Option (EPO)
  • Your Choice Preferred Provider Option (PPO)
  • Advantage PPO Saver
  • Active full-time or part-time
  • Regular work schedule: at least 16 hours per week
  • Must reside inside of EPO or PPO service area (exception for Advantage PPO Saver)
  • You need to actively enroll and make before-tax or after-tax payroll deduction contributions
  • Your cost depends on the plan and coverage level you elect and your salary
  • Cigna Out-of-Area PPO
  • Must reside outside of any Tufts Health Plan service area
  • Active full-time or part-time
  • Regular work schedule: at least 16 hours per week
  • You need to actively enroll and make before-tax payroll deduction contributions
  • Your cost depends on the plan and coverage level you elect and your salary
  • Granite Premier Choice EPO
  • Must reside in New Hampshire
  • Active full-time or part-time
  • Regular work schedule: at least 16 hours per week
  • You need to actively enroll and make before-tax payroll deduction contributions
  • Your cost depends on the plan and coverage level you elect and your salary
  • LifeSpan Premier Choice EPO
  • Must reside in Rhode Island
  • Active full-time or part-time
  • Regular work schedule: at least 16 hours per week
  • You need to actively enroll and make before-tax payroll deduction contributions
  • Your cost depends on the plan and coverage level you elect and your salary

BeWell Center Onsite Clinic
  • Employees, temporary staff, contractors, and the Board of Directors
  • No cost to employees 
  • Copay required for employees and Board of Directors with other medical insurance
  • Any additional out-of-pocket cost depends on specific medical plan coverage
  • Contractors or those with no medical insurance pay full cost of service provided

Dental Plan
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week
  • You need to actively enroll and make before-tax payroll deduction contributions
  • Your cost depends on the coverage level you elect

EyeMed Vision Care
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week
  • You need to actively enroll and make before-tax payroll deduction contributions
  • Your cost depends on the coverage level you elect

Flexible Spending Accounts
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week

You need to actively enroll and make before-tax payroll deduction deposits to your:

  • Health Care Spending Account; and/or
  • Dependent Care Spending Account

Short-Term Disability (STD) Coverage
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week
  • Core Coverage: Automatic enrollment; Tufts Health Plan pays full cost
  • Optional Coverage: You need to actively enroll and make after-tax payroll deduction contributions

Long-Term Disability (LTD) Coverage
  • Active full-time only
  • Regular work schedule: at least 32 hours per week
  • Core Coverage: Automatic enrollment; Tufts Health Plan pays full cost
  • Optional Coverage: You need to actively enroll and make after-tax payroll deduction contributions

Salary Continuance Plan

  • Active full-time or part-time employees classified as AVP & Above
  • Regular work schedule: at least 20 hours per week
  • Core Coverage: Automatic enrollment; Tufts Health Plan pays full cost

Basic and Optional Life Insurance
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week
  • Basic Life: Automatic enrollment; Tufts Health Plan pays full cost
  • Optional Life: You need to actively enroll and make after-tax payroll deduction contributions
  • Your cost for Optional Life depends on coverage amount, your age, smoker status and dependent election

Basic and Voluntary AD&D Insurance
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week
  • Basic AD&D: Automatic enrollment; Tufts Health Plan pays full cost
  • Voluntary AD&D: You need to actively enroll and make after-tax payroll deduction contributions
  • Your cost for Voluntary AD&D depends on coverage amount and dependent election

Long-Term Care Insurance (applies only to employees enrolled in the plan prior to 12/31/2011)
  • Employees and family members
  • Regular work schedule: at least 20 hours per week
  • You need to actively enroll and make after-tax payroll deduction contributions
  • Your cost depends on the coverage level you elect

Group Legal Plan
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week

You need to actively enroll and make after-tax payroll deduction contributions

Adoption Assistance Plan
  • Active full-time or part-time
  • Regular work schedule: at least 20 hours per week
  • Completion of the 90-day orientation period
  • Automatic Enrollment
  • Plan covers qualified adoption expenses only
  • Maximum reimbursement: up to $4,000 per eligible child

Employee Assistance Program
  • Employees and family members are eligible for the EAP

Automatic enrollment; Tufts Health Plan pays full cost

To contact the plan carriers directly, see the Contact Information section.

 

NEW EMPLOYEES

New employees receive a benefit plan enrollment package on or shortly after their first day of employment with Tufts Health Plan. The enrollment package contains: 

  • descriptive information about Tufts Health Plan's benefit plans
  • benefit plan contribution rates
  • enrollment instructions
 
If you are a new employee and need assistance with plan enrollment or other benefits-related issues, please contact Human Resources at ext. 52222.