City of Manchester, NH Official Website

Health Insurance Information and Forms

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Summary of Benefits & Coverage per ACA Guidelines

The purpose of the Summary of Benefits and Coverage (SBC) is to provide individuals with standard information so they can compare medical plans as they make decisions about which plans to choose. 


 Utilization Reports 

These reports were completed for the City of Manchester by Anthem Blue Cross & Blue Shield. They are in-depth analysis of the medical claims for the City of Manchester.


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Listed below are the health insurance plans available to the City of Manchester employees. Which plan is available to you depends on which union you are with and your date of hire. Please ensure that you look at the right information and complete the correct forms that correspond with your union and date of hire.
 

Quick Links For Forms And Information

Below are quick links to get you to the correct section that will have your health information and forms. Click on the link that coincides with your Union Affiliation:

Click on the links below for more information on the following:

Health Insurance Opt-Out Incentive Program Rules & Forms

This program offers a cash incentive to eligible City of Manchester employees who waive their right to enroll in the City's Health Insurance plan.

See below for rules and form:

IMPORTANT:
You must re-apply for the incentive each fiscal year! If you applied and received the incentive last year, you will not automatically get it again this fiscal year - you must re-apply for it.

If you are currently on the City's health insurance, you must also complete the Health Insurance Enrollment/Change form to cancel your health Insurance. Click here to go to the quick links to find the correct form based on your union affiliation.

The Incentive is considered ordinary income and therefore subject to Federal, State, Social Security, and Medicare taxes and City and State Retirement deductions.

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Summary of Benefits for all Health Plans

Below are the Summary of Benefits if Your Date of Hire is PRIOR TO:

AFSCME - 5/1/12
Airport Teamsters - 3/6/12
IAFF - 3/6/12
Library Teamsters - 3/6/12
MAFS - 2/21/12
MAPS - 2/7/12
MPPA - 2/7/12
Non-Affiliates - 3/6/12
PDSS - 10/15/2013
WaterWorks Union - 7/31/13
Welfare Teamsters - 6/5/12

Below are the Summary of Benefits if Your Date of Hire is AFTER the dates listed above:

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Aldermen, Dept. Heads, AFSCME, Airport Teamsters, IAFF, Library Teamsters, MAFS, Non-Affiliates & Welfare Teamsters

FORMS

  • Insurance Rate Chart
     
  • Health Insurance Enrollment / Change Form
    Use this form if your date of hire is PRIOR TO:
    AFSCME - 5/1/12
    Airport Teamsters - 3/6/12
    IAFF - 3/6/12
    Library Teamsters - 3/6/12

    MAFS - 2/21/12
    Non-Affiliates - 3/6/12

    Welfare Teamsters - 6/5/12
     
  • Health Insurance Enrollment / Change Form
    Use this form if you are a Department Head, Alderman or if your date of hire is AFTER:
    AFSCME - 5/1/12
    Airport Teamsters - 3/6/12
    IAFF - 3/6/12
    Library Teamsters - 3/6/12

    MAFS - 2/21/12
    Non-Affiliates - 3/6/12

    Welfare Teamsters - 6/5/12

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WaterWorks & PDSS Unions

FORMS

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MAPS & MPPA Unions

FORMS

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School Nurses 

FORMS

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 OTHER INFORMATION AND OTHER FORMS

 

URGENT CARE & WALK IN CLINIC INFORMATION

Save hundreds of dollars by going to Urgent Care or Walk in Facilities rather than the emergency room for minor injuries or ilnesses. Learn more below!

Walk in/ Urgent Care Facilities In NH

OTHER INFORMATION

OTHER FORMS

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