City of Boston – 2021 Opt-Out Program

f you choose to receive coverage under another medical plan outside of the City of Boston’s group coverage, you may waive the City of Boston plan and receive an annual opt-out payment through your paycheck. You may be eligible for the opt-out benefit for the 2021 plan year beginning July 1, 2021 – June 30, 2022.

  • The annual payment amount is either:
    • $1,000.00 for waiving Individual coverage or $1,500.00 for waiving Family coverage.
    Or, if stated in your collective bargaining agreement
    • $1,500.00 for waiving Individual coverage or $2,500.00 for waiving Family coverage.
  • To participate, employees must either be:
    • Currently enrolled in City medical coverage for at least one year and drop the coverage.
    Or, if stated in your collective bargaining agreement
    • You qualify if you were enrolled in a City of Boston health plan for at least one year at some point during your employment with the City and had previously dropped that coverage.

If you would like to participate, this personalized online form https://forms.gle/2rc64K9pKw86HPhx7 must be completed by Friday, June 18th, 2021.

For more information, please contact the Health Benefits Office by email at HBI@boston.gov or by phone at 617-635-4570.


** BPS Know Domain Issue – Work Around Instructions **

As a Boston Public School employee, after clicking your opt-out link, you may receive this error “You can’t respond to Opt-Out Form. Uploading files is not permitted when data loss prevention is enabled for your domain.”

You have two options to complete your Opt-Out Enrollment: If you have a personal Gmail account, please forward your email to that account. Ensure you are logged out of your BPS account, next log into your personal account, click your link and complete the form as instructed.
If you do not have a personal Gmail account. Please fully complete this blank form: https://forms.gle/fQkraRk911CQtc5Z6 and email HBI@boston.gov a copy or high-resolution photo of the following documents:

* A verification letter of alternative coverage as proof that you have continuing coverage elsewhere. This letter must be on employer letterhead or the certificate of credible coverage from the health insurance company. The following information should be included:

  1. Your Full Name
  2. Name of health plan you are enrolled in
  3. Date coverage began
  4. Indication that coverage is continuing
  5. Representative signature (if on employer letterhead)

* Copy of your marriage certificate or one of your dependent’s birth certificate, only if you are applying for the family benefit.

*** PLEASE NOTE: YOUR SUBMISSION IS NOT COMPLETED UNTIL YOU HAVE EMAILED ALL SUPPORTING DOCUMENTS TO HBI@boston.gov ***


IF YOU ARE COVERED UNDER ANOTHER MEDICAL PLAN OUTSIDE OF THE CITY OF BOSTON’S GROUP COVERAGE, YOU MAY WAIVE COVERAGE AND RECEIVE AN ANNUAL OPT-OUT PAYMENT THROUGH YOUR PAYCHECK.

ELIGIBILITY

  • To participate, employees must currently be enrolled in medical coverage through the City of Boston and drop the coverage during the Opt-Out Open Enrollment period for at least one year; or your collective bargaining agreement states that you qualify because you had City of Boston health insurance coverage for at least one year during your employment with the City and had previously dropped the coverage.
  • Employees are eligible for the payment if they have coverage under another plan. Other plans include:
    • Your spouse’s/ partner’s plan (as long as he or she is covered by someone other than the City of Boston, Boston Water & Sewer Commission or the Boston Public Health Commission);
    • A private plan;
    • A plan offered through a second employer (if you have another job that provides health care benefits); or
    • A retiree health plan from an employer other than one of the City of Boston groups.

ANNUAL OPT-OUT PAYMENT AMOUNT

  • The annual opt-out payment amount is $1,000.00 or $1,500.00 annually for waiving an individual health insurance plan or
    • $1,500.00 or $2,500.00 annually for waiving a family health insurance plan (whichever applies under your collective bargaining agreement).
  • The opt-out payment will be issued as a lump sum in one of your payroll checks.

Please note that amounts you receive under this plan are subject to federal, state, and Medicare taxes.

APPLYING FOR THE ANNUAL OPT-OUT PAYMENT

  • The City of Boston wants you to stay on the road to good health. Therefore, if you choose to waive medical plan coverage, you must certify that you have coverage under another medical plan by:
  1. Completing and signing a “Waiver of Health Insurance Coverage” application; and
  2. Providing written documentation of your other coverage on employer or group letterhead signed by an authorized representative of the employer or health insurance group providing the alternative coverage; and
  3. Copy of your marriage certificate or one of your dependent’s birth certificate.

IF YOU WAIVE COVERAGE AND NEED TO REJOIN THE CITY OF BOSTON HEALTH INSURANCE PROGRAM

If you waive coverage and then lose your other coverage during the City of Boston’s medical plan year, you can rejoin the plan, but you must:

  • Notify the City of Boston within thirty (30) days of the date of insurance cancellation;
  • Provide verification of loss of coverage; and
  • Enroll in a medical plan offered by the City

If you do not enroll in a City health plan within the 30 days, the City of Boston will not be responsible for any medical claims you incur after your loss of other coverage, and you must wait until the next Open Enrollment period to reapply for coverage.

REPAYMENT OF CASH BENEFIT PAYMENT

If you waive coverage, receive your cash benefit, and then rejoin the City of Boston’s medical plan at a later date, you must pay back a certain amount of the annual opt-out payment. The amount you pay back will be prorated to reflect the period for which you received payment minus the number of months that you will now be covered by one of the plans offered by the City of Boston.

Skip to content