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  • Human Resources Home
  • Open Enrollment

Open Enrollment

Municipal Employees

Open Enrollment: Now through June 30th

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July is our open enrollment month.  This is the only time of year in which you can make changes to your plan (i.e. add or drop dependents or enroll). It is also the only time a year that you can elect to participate in a Flexible Spending Account (FSA) or a Dependent Care Account (DCA), outside of life events. Please notify Human Resources if you wish to:

  • Make any changes to your health or dental plans.
  •  Sign up for FSA or DCA accounts. Please note that you must elect the FSA and DCA accounts every year. Your election does not carry forward from year to year. Any unused funds under $610 will rollover to the 2025-2026 plan year.

All Enrollment Forms should be submitted to Kelly Wood in Human Resources by Friday, May 30th, 2025

If you are not making any changes to your health and/or dental, or enrolling in the FSA, you do not need to submit anything to HR.

All enrollments forms are fillable and electronic signatures will be accepted. 

Completed enrollment forms can be sent through interoffice, dropped off to Human Resources in City Hall, or sent via email.  If you choose to send completed forms via email, please Encrypt the message for security purposes.  To encrypt, please add SECUREMAIL to the subject of the email. 

Health and Dental Insurance

HealthTrust Enrollment/Change Form- Fillable
AccessBlue 20 Cost Sharing (07/01/2025-06/30/2026)
AccessBlue 15/40 Cost Sharing (07/01/2025-06/30/2026)
Access Blue 20 and Access Blue 15/40 Benefit Comparison 2025
Access Blue 15/40 Summary of Benefits (07/01/2025-06/30/2026)
Access Blue 20 Summary of Benefits (07/01/2025-06/30/2026)
Delta Dental 15C (1386B, Fire)
Delta Dental 3F (PMA, SMA, Police, 1386A)
Active Employee Benefits Packet 2025
Active Employee Benefit Education 2025
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Flexible Spending Accounts

Available under the Flexible Spending Account (FSA) are the Health Care Reimbursement Account (HICA) and Dependent Care Assistance Account (DCA). This program allows you to take money out of our paycheck on a pre-tax basis, which you can use for eligible out of pocket health care expenses or your eligible dependent care expenses. Since the money you choose to put into these accounts is not considered taxable income, you save by paying less Federal, State (if applicable) and FICA taxes.

Medical Reimbursement Accounts

Employees may set aside up to $3,300 per year with a minimum of $5 per pay period. Can be used to pay for:

  • Medical Insurance Deductibles or Coinsurance
  • Uninsured Dental Expenses (including orthodontia)
  • Hearing Aids and Batteries
  • Vision Care Expenses, including exams, glasses, contact lenses, supplies and solutions and Lasik surgery
  • Support or corrective devices (such as orthopedic shoes)
  • And much more!

Dependent Care Reimbursement Accounts

Employees may set aside up to $5,000 per family per year, or a maximum of $208.33 per pay period. Can be used to pay for:

  • Day Care Expenses
  • Before/After School Care
  • Preschool Costs
  • Elderly Care
  • Day Camps

You must elect the FSA every year, your enrollment does not carry over from year to year. 

The FSA is deducted from 24 payrolls each fiscal year. 

List of FSA and DCA Eligible Expenses

FSA Election Form

FSA Enrollment Form - Fillable/E-Sign

INSURANCE RATES EFFECTIVE JULY 1, 2025-June 30, 2026

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*Premiums are subject to negotiations and may change pending City Council approval of collective bargaining agreements.

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UNIONS: SMA, PMA, NON-UNION, 1386A, 1386BPLAN TYPE EMPLOYEE MONTHLY COST
ACCESS BLUE NEW ENGLAND 20 (AB20 RX10/20/45)SINGLE$173.35
 TWO PERSON $346.70
 FAMILY$468.05
   
ACCESS BLUE NEW ENGLAND 15/40 (AB15 RX 10/20/45)SINGLE$99.84
 TWO PERSON$199.68
 FAMILY $269.57
   
UNIONS: PD PATROL, PD CIVILIANS, PD RANKINGPLAN TYPEEMPLOYEE MONTHLY COST
ACCESS BLUE NEW ENGLAND 20 (AB20 RX 10/20/45)SINGLE$196.47
 TWO PERSON$392.93
 FAMILY$530.46
   
ACCESS BLUE NEW ENGLAND 15/40 (AB15 RX 10/20/45)SINGLE $119.81
 TWO PERSON $239.62
 FAMILY$323.49
   
UNIONS: FIREFIGHTERS, FIRE OFFICERSPLAN TYPE EMPLOYEE MONTHLY COST
ACCESS BLUE NEW ENGLAND 20 (AB20 RX 10/20/45)SINGLE$208.02
 TWO PERSON $416.04
 FAMILY $561.66
   
ACCESS BLUE NEW ENGLAND 15/40 (AB15 RX 10/20/45)SINGLE $119.81
 TWO PERSON $239.62
 FAMILY $323.49

 

Retiree Open Enrollment

HealthTrust Retiree Application/Change Form
2025 Retiree Open Enrollment Notice
Early Retiree Benefit Education 2025
Open Access SBC (07/01/2025-06/30/2026) Early Retirees Only
Under 65 Retiree Benefit Packet 2025
Under 65 Retiree Benefit Comparison 2025
Medicare Advantage Plan (MAPD)
Medicomp III No Rx Supplemental Insurance

Mandatory Notices

CHILDREN'S HEALTH INSURANCE PROGRAM (CHIP)
HEALTH CARE EXCHANGE INFORMATION
Your Rights After A Mastectomy
Women's Health and Cancer Rights Act (Fact Sheet)
Special Enrollment Notice
2025 Open Enrollment Notice

BENEFITS QUESTIONS

Kelly Wood

Benefits Specialist
603-610-7270
More Info
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Human Resources

City Hall
1 Junkins Avenue, Portsmouth, NH 03801
Hours

Monday 8 AM – 6 PM

Tuesday – Thursday 8 AM – 4:30 PM

Friday 8 AM – 1 PM

Phone
(603) 610-7274
Fax
(603) 427-9995

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