Town of Westwood, MA
Home MenuBenefit Forms and Documents
Benefit Forms and Documents- For Benefit Eligible Employees
Please click on the links below for a listing of applicable benefit forms and documents.
Health
- Rates for FY25 (7/1/24 - 6/30/25)/ FY25 GIC Benefit Decision Guide
- GIC Website / Prescription Drug Info
- Qualifying Event Info
- Required Documents for Health Insurance Enrollment
- FY25 Health Insurance Enrollment/Waiver Form / GIC Transfer Form
- MEMBER PORTAL- For online enrollment
- Dependent Age 19 to 26 Form
- Reimbursement Info for Health Insurance Gap Period
Dental
- Rates for FY25 (7/1/24 - 6/30/25)
- Total Choice Plan Info / Delta Website
- Basic Plan Info / High Plan Info / Rollover Info
- Delta Dental Enrollment Form
- Delta Dental Claim Form
Flexible Spending Accounts
- Westwood Plan Highlights / Sentinel FSA Brochure
- Sentinel Enrollment Form
- Sentinel FSA Eligible & Ineligible Expenses
- Participant Guide
- Helpful Calculation Worksheet
- FSA Online Store (To purchase eligible items)
- Claim Form Dependent / Claim Form Health
Life Insurance
- Life Info- SCHOOL Employees
- Life Info- TOWN Employees
- School Enrollment Form/ Town Enrollment Form
- Evidence of Insurability Form (For requests above the guaranteed maximum or enrollment outside of new hire window or annual enrollment period)
- Group Insurance Certificate Change Form (To change/add beneficiary)
Long-Term Disability
457 - Mass Smart Plan
403(b) - TSA Consulting Group (School Staff Only)
- TSA Website (Any enrollments or changes in 403(b) plans are handled by TSA Consulting Group)
For questions regarding Salary Reduction Agreement (SRA): sraprocessing@tsacg.com or (888) 796-3786, Option 5
For questions regarding Recordkeeping: recordkeeping@tsacg.com or (888) 796-3786, Option 4
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