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- Health Insurance: BCBS
Health Insurance: BCBS
Hampshire County Group Insurance Trust
View the Hampshire Group Insurance Trust Files and Forms.
- 98 King Street, Northampton, MA
Phone: 413-584-1300
Enrollment Form
View the Enrollment Form (PDF).
- Eligibility / Enrollment Requirements (PDF) (Spouse and Dependents)
- Marital Status Affidavit (PDF) - Must be completed to enroll spouse
HMO Plan
- Employee Single Plan
- Employee + 1 Plan
- Family Plan
- HMO Plan Summary of Benefits (PDF) (effective 7/1/22)
- HMO Plan Summary of Benefits Chart (PDF) (effective 7/1/22)
- Find A Doctor (In-Network)
PPO Plan
- Employee Single Plan
- Family Plan
- PPO Plan Summary of Benefits (PDF) (effective 7/1/22)
- PPO Plan Summary of Benefits Chart (PDF) (effective 7/1/22)
MEDEX Plan (Over 65)
- Medex 2 Plan 2023 - Summary of Benefits (effective January 1, 2022)
- MedicareRx Prescription Plan 2023 - Summary of Benefits (effective January 1, 2022)
- Blue MedicareRx Enrollment Form
- Drug Formulary Book 2023
- Visit the Social Security website to learn more about Medicare (how to sign up, who qualifies, etc)
CVS Caremark
- New Prescription Information for HMO + PPO members only (effective 7/1/21)
- ExpressScripts is being replaced by CVS Caremark
- All affected members will receive a new CVS Caremark prescription card
- Visit CVS Caremark to create your account (it is quick and easy!)
- You do not have to use the CVS pharmacy - you may continue to use the pharmacy of your choosing
- CVS Caremark Prescription Summary (PDF)
- If you need help/have questions - call the 1-800 phone number on the CVS Caremark letter that you received
Are You (or Your Enrolled Spouse) Turning 65 Soon?
- If so, you will need to apply for Medicare at least 3 months prior to your 65th birthday.
- Please give our office a call so that we can help guide you through this time-restrictive process at 413-665-1400, ext. 102
Active Employee (or Spouse of)
- Apply for eligibility of Medicare Part A (deferring Part B until retirement)
- There is no cost to enroll in Part A and no change to insurance coverage.
- Treasurer's office needs a copy of the Medicare card before you turn 65.
Retired Employee (or Spouse of)
- Apply for Medicare Part A + B
- If eligible, member turning 65 will switch to MEDEX 2 with MedicareRx
- Treasurer's office needs a copy of the Medicare card, completed Enrollment Form, and MedicareRx before you turn 65.
No Copay Prescription Program
- Get name-brand prescriptions for free through CanaRx!
- Eligible for employee subscribers and their enrolled dependents.
- CanaRx Name-Brand Prescription Listing
Fitness Reimbursement (up to $150 / Year)
View the Fitness Reimbursement (PDF).
- New on-demand fitness classes - Unlimited access to 10-60 Minute workouts online!
- Yoga, Barre, HIIT, Kickboxing, Pre-Natal/Post-Natal, Cardio and much more!
- Access Code = HCGIT
Childbirth Class Reimbursement
(Up to $90 for 1st-time parents and $45 for refresher course)
View the Childbirth Class Reimbursement (PDF).
- No Cost Support for Subscribers
- Call-In Maternity Support: 800-392-0098 Monday through Friday 8:30 am - 4:30 pm
- 24/7 Nurse Care Line: 888-247-2583
- Visit the Maternity Page for BCBS
- Living Healthy Babies: BCBS Digital Pregnancy Resource Center
Identity Protection Services
Sign up for the Identity Protection Services for the following free of charge to BCBS members:
- Credit Monitoring
- Fraud Detection
- Credit and Identity Repair
Weightloss Program Reimbursement Form (up to $150 / Year)
View the Weightloss Program Reimbursement Form (PDF).
Subscriber Claim Form
View the Subscriber Claim Form (PDF).
Emergency Room Alternatives
View the Emergency Room Alternatives (PDF).