Benefits & Insurance Forms
For any Town of Lynnfield insurance benefit enrollments, changes or questions, please contact:
Kathleen Darragh darraghk@lynnfield.k12.ma.us
Health and Benefits Forms
Health Forms for use during Open Enrollment
Selection of Health InsuranceYou must submit this to Kathleen Darragh within 10 days of being hired
Boston Mutual Life Insurance (OPTIONAL) If you choose to decline life insurance, you still need to sign the refusal section.
Dental Insurance with Altus Dental (OPTIONAL)This form is optional. Submit only if you choose to pay for dental insurance.
Vision Insurance with Eye Med Enrollment and Change Form (OPTIONAL)This form is optional. Submit only to enroll in eye insurance.
Ameriflex Flexible Spending (OPTIONAL)This is an optional pre-tax benefit that can be spent on medical needs.
TSA Consulting Group: 403B Approved Vendors (OPTIONAL): This is also located on the Tax and Payrool Forms under Additional Benefits Information