Health, Dental, and Vision Insurance

Enrollment Form

Please use the 2025 Enrollment Form to elect, change, or decline insurance coverage for medical, dental, vision, Flexible Spending Account (FSA), and Health Savings Account (HSA)

2025 Enrollment Form

Health Insurance

Employees are offered a choice of two medical insurance plans through Blue Cross Blue Shield: HMO Blue New England or Blue Care Elect Saver (PPO). The cost of this benefit is shared between the College and the employee.

Coverage becomes effective on the first of the month following or coincident with the date of hire. Employees may elect individual, employee plus one, or family coverage. The plan covers non-dependent children up to the age of 26.

HMO Blue New England

In general, preventive and medically necessary health care services and supplies are covered when provided or authorized by your network primary care provider (PCP). This plan also covers emergency medical care you may need, even when the care is not provided or authorized by your PCP.

As an HMO member:

• You must choose a PCP from the Blue Cross Blue Shield network of providers. 
• In most cases, your network PCP must provide or authorize (provide a referral for) your care. 
• You pay a co-payment at the time you receive covered health care services.
• Certain services require an upfront deductible. After you satisfy this annual deductible, those services subject to the deductible are covered in full. Check the Summary of Benefits below for a more detailed list of services subject to the deductible.
• The deductible for this plan is $1,500 for employee only coverage and $3,000 for family coverage.

Please check the HMO Blue New England Plan Summary of Benefits and Coverage for more information.

If you do not already have a PCP who participates in the Blue Cross Blue Shield Plan network, you may find a doctor here.

Blue Care Elect Saver- PPO (Compatible with Health Savings Account)

As a PPO member:

• You are not required to choose a PCP. 
• You can seek covered health services from most licensed providers in or out of the Blue Cross Blue Shield Plan Network
• No referrals are needed. 
• This plan is compatible with a Health Savings Account, click here for additional information on HSAs.
• The deductible for this plan is $2,000 for employee only coverage and $4,000 for family coverage.

Please check the Preferred PPO Blue Saver Summary of Benefits and Coverage for more information.

Blue Cross Blue Shield Resources

• MyBlue Member App - Get health care information quickly and easily.
• 24-7 Nurse Care Line - Expert medical advice when you need it, fast.
• Fitness reimbursement for one individual or family membership: up to $150 back per year, per family for qualified expenses.
• Fitness Reimbursement Form: Return to BCBS
• Weight Loss reimbursement for one individual or family membership: up to $150 back per year, per family for qualified expenses.
• Weight Loss Reimbursement Form: Return to BCBS

Monthly Prescription Refills

 Contact CVS Mail Service Pharmacy via the CVS Customer Care Center or online portal to establish a patient profile, add payment information, and set up auto-refills if applicable.

Mail Service Pharmacy

Contacting Blue Cross Blue Shield

To contact the Blue Cross Blue Shield member services center, call 800.262.2583 or go online to their website here. 

Dental Insurance

Employees are offered dental insurance through Blue Cross Blue Shield. This is an employee-paid benefit. Coverage becomes effective on the first of the month following or coincident with the date of hire. Employees may elect individual, employee plus one, or family coverage. The plan covers dependent children up to the end of the month in which they turn 26.

The dental plan covers:

• 100% of preventative services
• 80% of basic restorative services
• 50% of major restorative services
• 100% of orthodontic services up to $1,000 lifetime maximum per individual

There is a $2,000 (per person) annual maximum for all coverages combined. 

BCBS Dental Blue Freedom Out of Network Claim Form

For more detailed coverage information, please refer to the Dental Benefits Summary of Benefits.

To contact the BCBS customer service center, call 800.262.2583 or visit their website here.

Please note: You can pay for out-of-pocket costs associated with dental work using a Flexible Spending Account.

Vision Insurance

Employees are offered vision insurance through Davis Vision. This is an employee-paid benefit. Coverage becomes effective on the first of the month following or coincident with the date of hire. Employees may elect individual, employee plus one, or family coverage. The plan covers non-dependent children up to the age of 26.

The vision plan covers: 

• Eye exam once every 12 months 
• Lenses once every 12 months 
• Frames once every 24 months
• Contacts* once every 12 months

 *(in lieu of lenses and frames)

For more detailed information on coverage, please refer to the Vision Benefits Summary and Frequently Asked Questions.

For a list of covered providers in your area, select your county ( Franklin, Hampden, Hampshire, Worcester ) or search for a provider on their website.

For reimbursement for an out of network claim for Davis Vision, please complete the Out of Network Claim form. 

To contact Davis Vision customer service, call 1.800.999.5431 or visit their website here.

This website is intended as a general overview of Hampshire College benefits plans only. Every effort has been made to summarize these programs accurately. In all cases, the actual provisions of each benefit plan will govern if there is any inconsistency between this site and Hampshire's formal plans or contracts.