City of Manchester, NH Official Website

Health Insurance Information and Forms

Health Plan Banner

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

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


Summary of Benefits and Coverage for all Health Plans

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. 

 

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Rate Charts and Enrollment Forms

Airport

AFSCME and School Nurses

IAFF and MAFS 

Library Teamsters

MAPS and MPPA

Non Affiliated

PDSS 

USWA Water Union

Welfare Teamsters

 


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. 

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

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

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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