All forms must be returned to the Payroll Department in the Treasurer’s Office of the Town Hall.
Health insurance is offered through MIIA- Blue Cross Blue Shield of MA. Your share of the medical insurance premium is deducted through your bi-weekly payroll. Coverage will begin the 1st of the month following 30 days from your date of hire, qualifying event or open enrollment. For more information about MIIA/BCBS you may visit: https://planinfo.bluecrossma.com/customblue/2022/miiatownofhopedale
HMO Blue Select- (Must live and PCP located in MA)
HMO Blue New England- (PCP Required)
PPO Blue Care Elect- (No Requirements)Please visit: https://member.bluecrossma.com/fad to check what plan your PCP accepts
The Town of Hopedale offers dental insurance through Altus. Coverage will begin the 1st of the month following 30 days from date of hire, qualifying event or open enrollment.
Voluntary benefits with American Fidelity:
FSA- Health/Medical- can elect up to $2,850, and or, Dependent Care- up to $5,000
Disability, Life, Hospital Indemnity, Cancer, Accident and Group Critical Illness Insurance.
For more information about any of these benefits please contact, Peter Battick (Town)- 800-654-8489 ext 2587 or Doug Mack (School)- 877-518-2337 office ext 757
The Town of Hopedale offers its employees the option of direct deposit. All or any portion of your pay may be deposited into a checking account, savings account, or received by check. This option is available to you at any time during your employment.* Please note: NO change will be made without a written consent, texts or email requests are not accepted.
State and Federal Forms:
Attached are all state and federal forms that need to be completed prior to receiving your first payroll check. These include the M-4, W-4, and I-9. Please return these forms along with a copy of your driver’s license, social security card or birth certificate.
The Town of Hopedale participates in the Worcester County Retirement System. This requires a mandatory deduction that is taken bi-weekly at a rate determined by your hire date. Most new hires contribute at a 9% rate with a 2% additional amount. For more information about your retirement benefits please visit: http://www.wrrboard.org
The Massachusetts Teachers’ Retirement System is the largest of the Commonwealth’s 104 contributory retirement systems. They provide retirement, disability and survivor benefits to more than 90,000 active educators and 62,000 retirees and survivors. MTRS contribution is mandatory for all certified employees (Unit A and B Members). https://mtrs.state.ma.us/
The Town of Hopedale offers these benefits upon your hire date. If you decide to change your health insurance carrier, or to enroll in any of the offered plans after your initial hiring, you must wait until the Town’s open enrollment period. The carriers do have guidelines for pre-qualifying events, which can be discussed at the payroll office.
|MIIA / BCBS Health- Enrollment form||396.42 KB|
|Altus Summary of Benefits||255.8 KB|
|Altus Preventive Rewards||468.2 KB|
|Altus- Enrollment form||235.13 KB|
|Direct Deposit Form||38.48 KB|
|Name / Address Change Form||22.61 KB|
|W-4 2022||171.83 KB|
|MA State Form||53.63 KB|
|I-9 Form||1.59 MB|
|Worcester Regional Retirement- Enrollment form||791.13 KB|
|Option D Benefit Selection Form- option 1||828.86 KB|
|Benefit Selection Form- option 2||775.12 KB|
|Nationwide- Obra 457 Acknowledgement form||20.9 KB|
|Nationwide- 457 Payroll Authorization Card||33.18 KB|
|Nationwide- Obra 457 withdrawel form||90.97 KB|