Active Employees

You and your dependents are each allowed up to the You are eligible for coverage under the Fund if:

Your employer listed below has made contributions to the Fund on your behalf:

• City of Cambridge
• Cambridge School Department
• Cambridge Health Alliance
• Cambridge Retirement Board

Your dependents may also be eligible to receive benefits. Your covered dependents include:

• Your spouse
• Your children

If you are eligible for the Cambridge Public Employees Dental and Vision Fund benefits, your Benefits Department will provide you with an enrollment form.

Be sure to complete the form accurately and return it promptly to your Benefits Department. The Benefits Department will then send your completed forms to the Fund Office.

If you need a copy of the enrollment form you can download it here.

New Employees of the City of Cambridge, the Cambridge School Department and the Cambridge Retirement Board

New employees who fail to submit an enrollment form to their Benefits Department by their effective date will not be enrolled until the Cambridge Public Employees Dental and Vision Fund Plan receives their enrollment form.

The Fund Office is unable to do retro enrollments of more than year. Your effective date will be based on the time we receive your enrollment form and/or effective date.

• Dental and Vision Benefits is an automatic deduction for City of Cambridge and Cambridge School Department employees regardless of enrollment.

New Employees of Cambridge Health Alliance

New Cambridge Health Alliance employees who fail to submit an enrollment form to their Benefits Department by their effective date will not be enrolled and will not be eligible for enrollment or any changes until the next Cambridge Health Alliance annual open enrollment period or if you have a special enrollment period qualifying event. 

When enrolling or adding eligible dependents, employees must complete an enrollment form provided by their Benefits Department.

You must also submit the necessary documentation that supports your dependent’s eligibility for benefits.

Examples of documentation include a:

• Marriage Certificate/License,
  • MUST BE A CERTIFIED LEGAL GOVERNMENT DOCUMENTATION FROM CITY/TOWN CLERK’S OFFICE
  • Church Certificate(s) WILL NOT BE ACCEPTED
• Dependent Children Birth certificate(s),
  • MUST BE A CERTIFIED LEGAL GOVERNMENT DOCUMENTATION FROM CITY/TOWN CLERK’S OFFICE
  • Hospital Announcements WILL NOT BE ACCEPTED
• Disabled Dependent Application, and
• Dependent Children Enrollment Application (age 19 – under 26) for dependent children ages 19 – under 26 (coverage would end on dependent(s) 26th birthday.
• Full-time student dependent children between the ages of 19 – under 25 that are not claimed on the members federal tax returns, but are dependent on the member for support, unmarried, and has no additional coverage – proof of student status required

Dependents of Cambridge Health Alliance Employees

Cambridge Health Alliance Employees who fail to enroll dependents when they first start working and become initially eligible will have to wait during open enrollment to add any dependents, unless you experience a special enrollment period qualifying event such as a birth of a child or marriage.

You will have 30-days from the qualifying event to enroll any dependents or will have to wait until the next open enrollment period.

You are able to enroll in Fund coverage when:

• You start work and become initially eligible for coverage;
  • and, if you are an employee of the Cambridge Health Alliance, you are also able to enroll;
• During the annual open enrollment period; or
• If you add or remove a dependent, generally due to a special enrollment period qualifying event.

The Benefits Department will send you an enrollment form when you are able to enroll.

Your Fund coverage will generally continue as long as your employer makes contributions to the Fund on your behalf.

Contact your Benefits Department if you are eligible for benefits and:

• Are waiting for or receiving workers’ compensation and;
• Are on a leave of absence.

Contact your Benefits Department for more information on continuing your coverage.

If you lose Fund coverage, you may be eligible to continue coverage in other ways. For more information, read about Continuation Coverage Eligibility. 

Workers’ Compensation

If you lose coverage and go on workers’ compensation or a leave of absence and then return to work, your coverage will resume on the first day of the month following the date you return to work.

Part-Time Status

If you make a voluntary change to part-time status, you will temporarily lose eligibility. That’s because your employer does not make contributions to the Fund for part-time workers.

You resume coverage on the first day of the month following the date when you resume full-time status.

Your Fund coverage will generally continue as long as A special enrollment period is a time when you are allowed to make changes to your Dental and Vision Fund Plan even though it is not an open enrollment period.

Normally, you are not allowed to enroll or make any changes to your Dental and Vision Fund Plan except during the annual open enrollment period.  However, certain qualifying events will trigger a special enrollment period allowing you to make changes for a brief period after the triggering event.

If you do not make the necessary changes to your Dental and Vision Fund Plan during the special enrollment period, you will have to wait until the next open enrollment period to make any changes.

You are eligible to change coverage outside of the Open Enrollment period for the following reasons:

1. You marry and want to enroll your spouse and/or newly eligible dependent children. A copy of your marriage certificate and birth certificate for dependent children is required.  For newly added dependent children ages 19 – under 26 a Dependent Children Enrollment Application (19 – under 26) will need to be completed and submitted.
2. You need to enroll a newborn or newly adopted child. In order to add a newly adopted child to your coverage, you must provide appropriate documents verifying the adoption in order to have the application accepted. To enroll a newborn you need to attach a copy of the certified birth certificate. A hospital birth announcement will not be accepted.
3. Your spouse provided you with coverage. As a result of death, divorce, or separation, you are no longer eligible for coverage under his or her plan.
4. Loss of your spouse’s job-based plan. Your spouse’s former employer provided you with coverage. He or she no longer works at the company that provided your plan. Or his/her company’s plan no longer provides coverage. As a result, you are no longer eligible for coverage.

You must let your Benefits Department know there has been a qualifying event. 

Your change in status (such as moving from individual only coverage to family coverage) must be consistent with the type of qualifying event. Once the change is processed, your new status will be effective as the date of the qualifying event.