Retiree Health Insurance Plan Change
At a glance
- What: a proposed change to the Medicare supplement plan for town retirees (about 575 on the Blue Cross Blue Shield plan), moving prescription coverage from three tiers to five with a new $700 per person prescription deductible, in exchange for a lower premium.
- Where it stands: introduced Oct 13 for discussion; the board is asked to decide at its Oct 27 meeting, ahead of the Jan 1 renewal. Patrick Welch recused himself (spouse is a town employee).
- Next: the Insurance Advisory Committee (union and retiree representatives) meets the week of Oct 19; staff will return with more data requested by the board.
Options
- Renew as is (Blue Cross): about a 10% premium increase. The town pays 75% of the retiree premium.
- Harvard Pilgrim, same design: about a 4% increase; on the new prescription design Harvard Pilgrim's quote was not competitive.
- Modified Blue Cross prescription design (advisor's recommendation): five tiers; no cost sharing for preferred generics; 17% co-insurance on the third tier, 35% on the fourth and 25% on specialty drugs; a new $700 deductible on prescriptions only. About $654 less premium per subscriber and roughly $1 million less cost to the town (as stated; some figures garbled in the captions). Medical coverage keeps no deductible and no copays. Fallon and Tufts plans stay available.
- Protection: the out-of-pocket prescription cap is set by Medicare ($2,100 in 2026, $2,400 in 2027); about 10% of subscribers (58) hit it this year; about 70% of prescriptions are in the lowest tier.
Concerns raised
- Heavy prescription users and the sickest retirees may see little or no savings; Mark Silverberg suggested using part of the savings to soften the deductible.
- Shelby Marshall asked for cost per prescription and per subscriber by tier, how many people would reach the $700 deductible, which drugs change tiers, and for the Harvard Pilgrim comparison to be visible, and warned the plan "sounds too good to be true".
- Others noted that doing nothing means a 10% increase and that savings also help all taxpayers.
Discussion time
About 32 minutes across 1 meeting (from transcript timestamps; approximate).
| Meeting | Minutes |
|---|---|
| 2026-10-13 - Select Board | 32 |
Log
- 2026-10-13 - Select Board - Introduced by the Town Manager and staff; questions on fairness to heavy users and requests for more data; decision expected Oct 27.
- 2026-10-27 - Select Board - Agenda: decision on the retiree health plan insurance change. Outcome not yet known.