Benefits & Insurance Forms

For any Town of Lynnfield insurance benefit enrollments, changes or questions, please contact:

Cassandra Murphy, Payroll and Benefits Administrator 781-334-9435

Required Benefit Forms for New Staff

Current Staff may also complete these forms during open enrollment

GIC (Health Insurance) Information Use this page to explore your health insurance options, then the page below to indicate your selection

Selection of Health Insurance (Required for new hires) You must submit this to Cassandra Murphy within 10 days of being hired

Boston Mutual Life Insurance (Required for new hires) If you choose to decline life insurance, you still need to sign the refusal section.

Benefits Checklist (Required for new hires) Please complete and submit.

Dental Insurance with Altus Dental (Optional) This form is OPTIONAL. Submit only if you choose to pay additional money for dental insurance.

Vision Insurance with Eye Med Enrollment and Change Form (Optional) Use this form to enroll in eye insurance or to change your current eye insurance

Ameriflex Flexible Spending (Current Staff Only) This is an option pre-tax benefit that can be spent on medical needs.

403B Information