2024-2025 Resident and Fellow Salary Benefits Sheet FULL

2024-2025
Benefits Guide
RESIDENTS AND FELLOWS
The Hub>Departments>Benefits
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Compensation and Paid Time Off
Salary Resident & fellow salaries for the 2024-2025 academic year are:
PG1- $70,000 PG3- $76,200 PG5- $82,400 PG7- $90,000 PG9-$97,000
PG2- $73,000 PG4- $79,300 PG6- $86,000 PG8- $94,000
Chief Resident Internal Medicine, Pediatrics Only- $94,300
Paid Time Off (PTO) Residents /fellows receive 4 weeks paid vacation and 5 days of sick time during each one-year appointment.
Educational Leave Educational leave is granted for professional and educational meetings at the discretion of the Program Director.
The leave is not deducted from your vacation time. Financial support is provided to residents and fellows who present their
research work at professional meetings.
Professional Liability Insurance and Licensure

Professional Liability Insurance Through the Baystate Health Insurance Company, Ltd. (BHIC), a self-insured professional liability
program, Baystate provides professional liability insurance to all residents and fellows. This coverage includes legal representation
for claims related to your professional activities during employment, in the amounts of $3,000,000 per occurrence and $15,000,000
in the aggregate. A purchased umbrella policy provides additional coverage up to a maximum of $20,000,000. This program includes
“tail coverage” for claims made after you leave employment at Baystate Health.
License Fees Baystate Health covers the cost for a Massachusetts limited medical license.
Health Insurance Benefits
These benefits become effective on your date of hire. Choose individual, employee + child, employee + spouse, or family
coverage.
Medical Insurance Baystate contributes significantly to the cost of the medical insurance plans. Through Health New England
(HNE), Baystate offers three medical plans, the Advantage Plus PPO Medical Plan, Advantage Plus HMO Medical Plan and the
H.S.A. Medical Plan. A spousal surcharge is added to the cost of the team member paycheck contribution if your covered spouse
is eligible for coverage through their employer. The surcharge can be waived if certain circumstances apply.
The Advantage Plus PPO Medical Plan is a Preferred Provider Organization (PPO) plan. This plan charges the highest bi-weekly
premiums of all three plans, however there is no deductible for services in the Baystate/Baycare network and out-of-pocket
expenses across all network tiers is generally less, compared to the H.S.A. plan. Services and prescriptions do have copays and
coinsurance, but many services within the Baystate and Baycare network tier have no copay.
The Advantage Plus HMO Medical Plan is a Health Maintenance Organization (HMO) plan. In this plan, your bi-weekly premium
charge is about 25% less than the Baystate Advantage Plus PPO Medical Plan, however the HMO plan only covers services in the
Baystate/Baycare and HNE network tiers except emergency care and services that are not available in-network (requires pre-
approval). The plan requires that you designate a Primary Care Provider (PCP), however unlike many other HMO plans, this plan
does not require a referral from your PCP in order to see a specialist. Deductibles and copays in the covered tiers are the same
as the Advantage Plus PPO Medical Plan.
The H.S.A. Medical Plan is a high deductible health plan with a Health Savings Account. The plan charges the least amount of bi-
weekly premiums of all three plans, however you will pay 100% of your medical/pharmacy costs (excluding covered preventive
services), until your deductible is met. By contributing to a Health Savings Account, you can set aside pre-tax dollars (up to
$4,150 per year for individuals and up to $8,300 for families) to pay for qualifying medical expenses during the plan year and in
the future. Baystate helps to fund your H.S.A. by contributing $400 annually for individual coverage and $800 annually for all
other coverage levels. Baystate makes a total annual contribution of $500 for full-time, individuals earning less than $35,000
enrolled in individual coverage, and $1,000 for full-time employees earning less than $75,000 enrolled in the family coverage.
H.S.A. funds rollover from year to year and the money is yours to use, save, invest, and ultimately pay for medical expenses and
premiums in retirement.
For further information on how to select the right medical plan for you, visit The Hub>Quick Links>Benefits>Medical Insurance
Health Insurance Benefits continued
All Medical Plans Include:
Preventive care services covered at 100% - no deductible or copay for these services obtained in-network.
Pharmacy prescription drug coverage.
Access to telemedicine, medical and behavioral health services through Teladoc. Doctors and clinicians are available 24x7x365 by
phone, online video or mobile app.
Network tiers - You can save on your out-of-pocket health care costs if you select services within the Baystate Health and Baycare
provider networks.
A limit to the amount you have to pay out-of-pocket. This out-of-pocket maximum limits the amount you pay in deductible,
copayment and coinsurance costs before the plan begins paying 100% of covered medical expenses.
Dental Insurance The plans include preventive care as well as basic and major restorative care. The Value Plan provides coverage
of up to $1,000 per person per calendar year. The Choice Plan provides coverage of up to $2,000 per person per calendar year and
orthodontia coverage.
Vision Insurance Available for purchase to cover eye exams, glasses, contact lenses, & discounts for laser vision correction surgery.
Financial Building Benefits and Support

Retirement Package– 403(b) Plan* You are automatically enrolled at 3% of your pay, but you can change the contribution
(more, less, or opt out) at any time. Your Fidelity retirement kit will arrive at your home about a month after your hire date.
Your Voluntary Contributions - You can elect any percent of your pay up to $23,000 per year if under age 50 or any percent of
pay up to $30,500 per year if age 50+. Contributions can be made to the before-tax account, the after-tax Roth account, or both.
Your contributions are immediately 100% vested.
Baystate Matching Contribution - Baystate matches $0.50 for each $1 on the first 4% of your contributions which equates to a
maximum match of 2% of your pay. Matching contributions are made biweekly and there is a 3-year vesting requirement.
Baystate Service Years Contribution Baystate makes an additional annual contribution based on your years of service which is
provided as a percentage of your pay. Contributions are made each spring, and you must be employed+ on December 31st to
receive it. There is a 3-year vesting requirement. (+except for retirement or disability status)
0-10 years of service: 3% 11-20 years of service: 4% 21+ years of service: 5%
Health and Dependent Care Flexible Spending Accounts (FSA) A Health Care FSA can be used for out-of-pocket healthcare care
expenses, including medical, dental and vision and you can contribute up to $3,200 (pre-tax) annually. A maximum of $640 from
the Health Care FSA is eligible for rollover each year if you continue to contribute to the FSA the following year. A Dependent
Care FSA can be used for out-of-pocket dependent care expenses, including daycare, eldercare, etc. and you can contribute up to
$5,000 (pre-tax annually (no rollover). IRS rules and regulations impose certain nondiscrimination testing requirements on many
of our benefit plans, including the Dependent Care FSA Plan. The purpose of the testing is to prevent the plan from favoring
certain people the IRS considers to be highly compensated employees. Generally, these individuals are defined as having earned
$150,000 or more in 2023. Because of Baystate’s testing results in recent years, dependent care FSA pre-tax contribution
elections for highly compensated employees are limited to $1,518 for the 2024 plan year.
Free Unlimited Financial Coaching – Free and unlimited money coaching on any financial topic through My Secure Advantage.
This expert team of money coaches provide confidential, unbiased support for every stage of life.
529 College Savings Plan This is an education savings plan designed to help you set aside funds for future college expenses,
offering significant tax benefits and an exceptional degree of control and flexibility. 529 plans can be used for virtually any public
or private institution of higher education. This is a part of the BenefitsPlus offerings.
Income Protection Benefits

Baystate provides income protection, by paying a percentage of your salary for a specified period of time, in the event you are
ill or injured and cannot perform the duties of your job. Short-term disability and long-term disability become effective on
your date of hire, provided you are actively at work. Life Insurance is effective the 1st of the month following date of hire.
Short-Term Disability (STD) Baystate pays 60% of your annual base earnings up to 20 weeks, for full-time and part-time benefit-
eligible team members, up to a maximum weekly benefit of $3,500. You can choose to purchase an additional 10% or 20% STD
buy-up insurance to supplement the 60% coverage (salary maximums apply). The maximum weekly benefit for the buy up
coverage is $7,500.
Income Protection Benefits continued
Long-Term Disability (LTD)
Full-time Medical Residents: Baystate pays 60% of your annual base salary, up to a monthly benefit maximum of $5,000.
State-Specific Paid Family Medical Leave: You may be eligible for job protected paid time off for your own illness as well as
family leave to welcome a new child, take care of an ill or ailing relative or for certain military circumstances, if you work in a
state that has an applicable law. Make sure you understand how the leave program in your state of residence may impact your
need for supplemental short-term disability coverage. For information about state-specific leave programs, contact
disabilitymanagement@baystatehealth.org
Term Life Insurance Baystate provides full-time and part-time employees an amount of Basic Life insurance equal to their
annual earnings, rounded to the next higher $1,000. The plan includes an option for employees to purchase additional insurance
up to 5 times their annual earnings (subject to guaranteed issue and coverage maximums). Full-time and part-time employees
also have the option to purchase coverage for a spouse and/or dependents. Medical underwriting may be required.
BenefitsPlus - These additional benefits are available for purchase at group discounted rates.
Legal Plan Insurance Covers legal services for almost any personal legal matter.
Automobile Insurance Discounted policies that cover theft, collision, bodily injury, etc., with multiple carrier options.
Homeowner Insurance Coverage is available for both homeowners and renters.
Pet Insurance & Pet Wholesale Discounts Insurance for dogs, cats, and birds for medical problems, and conditions related to
injuries and illnesses, available through Nationwide. Wholesale discount pricing for pet supplements, Rx and specialty foods,
available through PETplus.
Identity Protection Insurance ID Watchdog provides ID theft protection; monitors credit reports, social networks, black market, etc.
to protect personal information.
Critical Illness Insurance Critical Illness insurance pays cash benefits directly to you, if you are diagnosed with a covered disease or
condition. You can use this money to pay for any expenses. This is designed to complement your medical insurance coverage, not
replace it.
Accident Insurance Accident Insurance pays cash benefits directly to you, for covered accidents and injuries. You can use this
money to pay for any expenses. This is designed to complement your medical insurance coverage, not replace it.
Hospital Confinement Indemnity Insurance Hospital Indemnity insurance pays a lump-sum benefit for each day you are in the
hospital—for whatever reason. You can use this money to pay for any expenses. This is designed to complement your medical
insurance coverage, not replace it.
Whole Life Insurance Coverage is available for one to five times salary, with cash value available to you, your spouse, children, and
grandchildren. Medical underwriting is required for some amounts.
To learn more about these benefits, visit: Workday>Benefits Application>BenefitsPlus tile under external links
Team Member Well-being - Your Well-being and Worklife Benefits

Our Team Member Well-being program offers a collection of resources designed to enhance the health, well-being and work life
balance of Baystate Health employees and your loved ones. Program are provided to you at no-cost, unless otherwise noted:
Support for your Essential Needs Monthly incentives reward you for taking action to improve your well-being, plus use the online,
customized resource center to connect you to Baystate and community resources for help with financial assistance, transportation,
childcare, housing, mental health, social connection, food access, and more.
Onsite Emotional Support Confidential counseling available with our internal EAP provider. In-person and virtual appointments
available during normal business hours. 6-session per issue, per year at no cost. Other support available for individuals and groups.
Personal and Emotional Well-being Counseling, teletherapy, lifestyle coaching, fitness and nutrition resources, & more.
Financial Well-being Unlimited telephonic money coaching to cover any financial need from budgeting to investing, plus online
education, videos, tools, calculators, and more.
Worklife Integration Back-up Care Reimbursement program to help you when your child(ren) can’t go to school/daycare, personal
assistance offering research and referral support for your daily living needs, parenting, eldercare & aging, and more.
To learn about these resources and self-select based on need, visit: The Hub>Quick Links>Baystate Healthy or access from any
device outside the Baystate network by going to Baystatehealth.org>Employee Resources>Baystate Healthy.
Additional Benefits
Meal Allowance Provided during required night float, extended day shifts and overnight shifts in-hospital.
White Coat Laundry Service Complimentary white coats and laundry service is provided.
Parking Free parking and shuttle service is provided.
Up to $400 Wellness Reimbursement Baystate Health- Health New England plan members receive up to $200 cash back for those
on an individual medical plan, and up to $400 cash back for those on a family medical plan, with the purchase of a variety of
wellness activities or products including; gym memberships, wellness and fitness classes- live and online, select stress reduction
programs, fitness equipment, golf and ski tickets and CSA farm shares. Login to my.healthnewengland.org and select Forms to
submit. To receive the full $400 a separate reimbursement form must be submitted to HNE by at least two plan members.
Massage Reimbursement Up to two, 60-minute massage therapy visits per calendar year for Baystate Health- Health New
England plan members. The form is located at https://healthnewengland.org/forms. H.S.A. Plan Members: Deductible applies, and
reimbursement will occur only after your deductible has been met.
Adoption Assistance Up to $3,000 per child. Maximum $6,000 annually.
Perkspot Discount Center Thousands of national and local discounts.
Educational Assistance Reimbursement up to $5,250 for registration, books and coursework from accredited schools.
First-time Homebuyers Assistance Up to $7,500 in forgivable loans toward the purchase of your first home. Eligible towns include
Springfield, Westfield, Palmer and Greenfield.
Credit Union Membership Take advantage of lower fees, low interest rates and free checking.
The MacDuffie School Student Discount 25% tuition discount offered to Baystate Health employee’s children. Up to a 90%
discount possible based on financial need.
Caring for Colleagues This program (funded by Baystate Health employee donations) offers emergency assistance to employees
experiencing a sudden loss of income, family crisis, or unforeseen circumstances. Donations may be tax deductible. The benefit is up to
$1,200 per year. Lifetime benefit maximum is $4,800.
Back-up Childcare Reimbursement Baystate now provides up to a $100 reimbursement per day, up to 5 days per year for back-up
care arranged on your own. Employees are responsible for selecting an alternative caregiver.
Contact Us
For questions about your benefits, call HRAnswers at 413-794-4747. You have 30 days from your date of hire or job transfer to
enroll in benefits. After you start employment, visit Baystate Health’s employee intranet site where you will find comprehensive
information about your benefits: The Hub>Quick Links>Benefits
The information contained in this document applies to all full-time and part-time team members who are regularly scheduled to work 16 or more
hours (or 15 hours or more at Baystate Home Health) a week. This document is intended to provide a summary of key elements of the Total
Rewards for most Baystate Health team member positions. In the event there is a discrepancy between this document and the approved
complete plan document, the complete plan document will govern.
Baystate Health Team Members Medical Plan Comparison
2024 Coverage Summary & Rates
Plan Rates effective January 1- December 31, 2024
Advantage Plus HMO Advantage Plus PPO
H.S.A. Medical Plan*
Medical Plan Medical Plan
Premium Rates (Bi-weekly paycheck deduction)
Full Time Employees
You Pay Baystate Pays You Pay Baystate Pays You Pay Baystate Pays
(30+ hours/week)
Individual $56.31 $263.08 $70.39 $255.20 $32.63 $250.27
Employee + Child $113.94 $460.97 $142.42 $443.64 $75.64 $433.58
Employee + Spouse $132.94 $537.79 $166.17 $517.59 $88.26 $505.84
Employee + Working Spouse $179.09 $537.79 $212.32 $517.59 $134.41 $505.84
Family $183.57 $742.66 $229.47 $714.75 $121.86 $698.54
Family + Working Spouse $229.73 $742.66 $275.62 $714.75 $168.02 $698.54
Part Time Employees
You Pay Baystate Pays You Pay Baystate Pays You Pay Baystate Pays
(16-29 hours/week)
Individual $112.62 $206.76 $140.78 $184.81 $65.26 $217.65
Employee + Child $202.73 $372.18 $253.41 $332.66 $117.47 $391.75
Employee + Spouse $236.52 $434.22 $295.64 $388.11 $137.04 $457.05
Employee + Working Spouse $282.67 $434.22 $341.80 $388.11 $183.19 $457.05
Family $326.61 $599.62 $408.26 $535.96 $189.24 $631.16
Family + Working Spouse $372.77 $599.62 $454.42 $535.96 $235.40 $631.16
*H.S.A. Contributions: The IRS allows H.S.A. plan members to contribute to a tax-advantaged Health Savings Account (up to
$4,150/year for individuals and $8,300/year for all other coverage levels). Baystate makes an annual contribution of $400 (individual)
and $800 (family) to your H.S.A. and this contribution counts toward your annual limit. Employees over the age of 55 may contribute
an additional $1,000.
Enhanced H.S.A. Employer Contribution – New This Year!
Baystate makes a total annual contribution of $500 for full-time, individuals earning less than $35,000 and $1,000 for full-
time employees who earn less than $75,000 enrolled in the family coverage.
Tier 2 Enhancement for the Advantage Plus PPO Plan and H.S.A. Medical Plan – New this Year!
Members who require care within HNE’s service area will continue to access care using the Health New England network. Members of
the Advantage Plus PPO Medical Plan and H.S.A. Medical Plans that require care outside of Health New England's service area will
now access care using the national UnitedHealthcare Options PPO network. This new network includes over 684,000 physicians and
5,400 hospitals.
Health Insurance Credit - Full-time employees who earn less than $50,000 annually, and are enrolled in employee +child, or family
coverage automatically receive a discount on medical premiums.
• If your earnings are $30,000 or less you will receive a $28.85 bi-weekly credit.
2024 Advantage Plus HMO Medical Plan
Tier 1: Tier 2: Tier 3:
Baystate & Baycare HNE Out of Network
Deductible $0 $1,000/$2,000 No Coverage

In-Network Deductibles and OOP max’s cross-accumulate
Out of Pocket Max $2,000/$3,500 $3,000/$5,000 No Coverage
Preventive Care Exams No deductible, $0 copay No deductible, $0 copay No Coverage
Primary Care (PCP) No deductible, $25 copay No deductible, $35 copay No Coverage
Specialists No deductible, $40 copay No deductible, $50 copay No Coverage
Inpatient- Hospital No deductible, $700 copay Deductible, then 20% coinsurance No Coverage
Inpatient - Physician No deductible, then $0 copay Deductible, then $0 copay No Coverage
Inpatient- Behavioral No deductible, $700 copay Deductible, then 20% coinsurance No Coverage
Outpatient – Hospital No deductible, $400 copay Deductible, then 20% coinsurance No Coverage
Outpatient – Physician No deductible, $0 copay Deductible, then 20% coinsurance No Coverage
Outpatient – Behavioral No deductible, $25 copay No deductible, $25 copay No Coverage
Emergency Room No deductible, $150 Copay (Copay waived if admitted directly from ER). No Coverage
$0 Copay for Behavioral Health Services, $0 for all other medical services
Teladoc (virtual) Deductible does not apply.
No Coverage
Lab & Radiology*

(Ultrasound, X-rays, Non- No deductible, $0 copay Deductible, then 20% coinsurance No Coverage
Routine Mammogram)
Imaging* (CT Scans, MRIs,
MRAs, Nuclear Cardiac and No deductible, $100 Copay; Deductible, then $150 copay; (max. 3
No Coverage
PET Scans) Prior approval (max. 3 copays per year) copays per year)
required.
No deductible, then 5% coinsurance;
Durable Medical Equipment
applies to DME billed by a Tier 1 No deductible, then 20% coinsurance No Coverage
(DME) physician or hospital
Outpatient Short-Term Rehab No deductible, $25 copay No deductible, $35 copay No Coverage
*To receive Tier 1 cost sharing, services must be performed at a Tier 1 facility, please alert your provider.
Pharmacy Coverage
Pharmacy Tiers Baystate Health Pharmacy Mail Order Program Retail Pharmacy
$10 Copay (up to 30-day supply

Generic $20 Copay (up to 90-day supply)
$40 Copay (90-day supply) $10 Copay (up to a 30- day supply)

Brand Formulary $60 Copay (up to 90-day supply)

Brand Non-Formulary $100 Copay (up to 90-day supply)
2024 Advantage Plus PPO Medical Plan
Tier 2:
Tier 1: Tier 3:
HNE Providers/ Extended
Baystate & Baycare Out of Network
Network
Deductible $0 $1,000/$2,000 $2,500/$5,000

Out of Pocket Max $2,000/$3,500 $3,000/$5,000
$10,000/$15,000
Preventive Care Exams No deductible, $0 copay No deductible, $0 copay Deductible, then 60% coinsurance
Primary Care (PCP) No deductible, $25 copay No deductible, $35 copay Deductible, then 60% coinsurance
Specialists No deductible, $40 copay No deductible, $50 copay Deductible, then 60% coinsurance
Inpatient- Hospital No deductible, $700 copay Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Inpatient - Physician No deductible, $0 copay Deductible, then $0 copay Deductible, then 60% coinsurance
Inpatient- Behavioral No deductible, $700 copay Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Outpatient – Hospital No deductible, $400 copay Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Outpatient – Physician No deductible, $0 copay Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Outpatient – Behavioral No deductible, $25 copay No deductible, $25 copay No deductible, $50 copay
Emergency Room No deductible, $150 Copay (Copay waived if admitted directly from ER).
$0 Copay for Behavioral Health Services, $0 for all other medical services
Teladoc (virtual) Deductible does not apply.
Lab & Radiology*

(Ultrasound, X-rays, Non-Routine No deductible, $0 copay Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Mammogram)
Imaging* (CT Scans, MRIs, MRAs,

No deductible, $100 copay Deductible, then $150 copay
Nuclear Cardiac and PET Scans) (max. 3 copays per year) (max. 3 copays per year)
Deductible, then 60% coinsurance
Prior approval required.
No Deductible, 5% coinsurance
Durable Medical Equipment
applies only when billed by Tier 1 No Deductible, 20% coinsurance Deductible, then 60% coinsurance
(DME) physician or facility
Outpatient Short-Term Rehab No deductible, $25 copay No deductible, $35 copay Deductible, then 60% coinsurance
Pharmacy Coverage
$10 copay (up to a 30-day supply)

Generic $20 copay (up to a 90-day supply)
$40 copay (up to a 90-day supply) $10 copay (up to a 30-day supply)

Brand Formulary $60 copay (up to a 90-day supply)

Brand Non-Formulary $100 copay (up to a 90-day supply)
2024 H.S.A. Medical Plan
Tier 2:
Tier 1: Tier 3:
HNE Providers/ Extended
Baystate & Baycare Out-Of-Network
Network
$2,000/$4,000 $4,000/$8,000
Deductible $1,600/$3,200

Out of Pocket Max $3,200/$6,000 $4,000/$8,000 $10,000 / $15,000
Preventive Care Exams No deductible, $0 copay No deductible, $0 copay Deductible, then 60% coinsurance
Primary Care (PCP) Deductible, then 10% coinsurance Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Specialists Deductible, then 10% coinsurance Deductible, then 30% coinsurance Deductible, then 60% coinsurance
Deductible, then 10% coinsurance Deductible, then 30% coinsurance Deductible, then 60% coinsurance
Inpatient- Hospital

Inpatient - Physician Deductible, then 10% coinsurance Deductible, then 30% coinsurance

Inpatient- Behavioral Deductible, then 10% coinsurance Deductible, then 10% coinsurance
Outpatient – Hospital Deductible, then 10% coinsurance Deductible, then 30% coinsurance Deductible, then 60% coinsurance
Outpatient – Physician Deductible, then 10% coinsurance Deductible, then 30% coinsurance Deductible, then 60% coinsurance
Outpatient – Behavioral Deductible, then 10% coinsurance Deductible, then 10% coinsurance Deductible, then 30% coinsurance
Deductible, then 30% coinsurance. Out-of-Pocket expenses provided by Tier 2–3 providers apply towards the
Emergency Room Baystate & Baycare tier.
Teladoc (virtual) No deductible, $0 Copay for Behavioral Health Services, $0 for all other medical services Deductible does not apply.
Lab & Radiology*

(Ultrasound, X-rays, Non-Routine
Mammogram) Deductible, then 10% coinsurance Deductible, then 30% coinsurance
(max. 3 copays per year) (max. 3 copays per year)
Imaging* (CT Scans, MRIs, MRAs,
Nuclear Cardiac and PET Scans)
Prior approval required.
Durable Medical Equipment Deductible, then 30% coinsurance
applies only when billed by Tier 1 Deductible, then 60% coinsurance
(DME) physician or facility
Outpatient Short-Term Rehab Deductible, then 10% coinsurance Deductible, then 20% coinsurance Deductible, then 60% coinsurance
Pharmacy Coverage
Generic
Brand Formulary Deductible, then 10% coinsurance Deductible, then 30% coinsurance Deductible, then 40% coinsurance
Brand Non-Formulary
Baystate Health Medical Plans
What’s the difference?
Advantage Plus HMO Advantage Plus PPO H.S.A. Plan HDHP
Medical Plan Medical Plan
What’s the one thing I should know to help me decide which plan to choose?
This plan is a low-cost option for those who This plan may be best for those who need This plan may be best for those who need
already are or are willing to seek services several services/prescriptions throughout few services/prescriptions throughout the
only within the Baystate/Baycare and HNE the year and may also have some year and are committed to funding their
networks. providers/facilities that are in the Extended H.S.A. to offset higher out-of-pocket
Network and/or Out-of-Network. expenses and/or want to use the H.S.A. to
invest in their healthcare for the future.
Do I need to designate a Primary Care Physician (PCP)?
Yes No No
Is a referral from my PCP required to see a specialist?
No No No
Are out-of-network services covered?
No, unless service is not offered in-network Yes Yes
How much is the employee portion of the plan premiums?
Lower premium cost than the PPO plan. Highest cost premiums of all plans Lowest cost premiums of all plans
How much is the deductible?
No deductible in Baystate/Baycare tier. No deductible in Baystate/Baycare tier. The deductible is highest in this plan, and
Lower deductible for the HNE tier, compared Lower deductible for other tiers, when you will pay out-of-pocket for services
to H.S.A. plan. compared to H.S.A. plan. (outside of certain preventive care) until
the deductible is met .
How does the Deducible work in a Family Plan?
Each plan member’s medical expenses count Each plan member’s medical expenses Plan members contribute to one family
towards their own individual deductible and count towards their own individual deductible, even if just only one family
the family deductible. deductible and the family deductible. member is accessing healthcare services.
How do copayments & coinsurance work?

This plan charges mostly copays, which are This plan charges mostly copays, which are Once you meet the deductible, this plan
fixed dollar amounts. Therefore, costs in this fixed dollar amounts. Therefore, costs in charges coinsurance, which is a percentage
plan are overall predictable. this plan are overall predictable. of the total cost of service. Therefore,
costs remain more variable.
Which tax-free savings accounts area available?

This plan allows you to have a Flexible This plan allows you to have a Flexible This plan comes with a Health Savings
Spending Account to pay for qualifying Spending Account to pay for qualifying Account and Baystate contributes money to
medical expenses before tax. Up to $640 of medical expenses before tax. Up to $640 this account. Funds rollover from year to
unused funds can be rolled over if you re- of unused funds can be rolled over if you year. A limited-purpose FSA is also
enroll in the FSA for the next plan year. re-enroll in the FSA for the next plan year. available for dental and vision expenses
How does prescription coverage work?

Prescription drug costs are paid through Prescription drug costs are paid through You are responsible for 100% of
copayments and therefore you do not need copayments and therefore you do not need prescription drug costs until you meet your
to first meet the deductible. Your copay will to first meet the deductible. Your copay will medical plan deductible. Costs count
count towards your plan’s out-of-pocket count towards your plan’s out-of-pocket towards your plan’s deductible and out-of-
maximum. maximum. pocket maximum.
Medical Plan Service Network Tiers FAQ
What are Network Tiers?
All of our medical plans offer tiered networks in order to offer flexibility and a larger list of providers.
Regardless of which BH-HNE medical plan you choose, your medical costs depend on the network tier your
providers and facilities are in. Deciding which network tier to seek services under is separate from selecting a
medical plan and only comes into play when you use medical services.
How can the Network Tiers save me money?
If your provider is in a higher cost tier and you don’t want to switch, you can still lower
costs by using Tier 1 for things like lab work, prescriptions, imaging, and other referrals.
Your provider and the facilities your provider uses, may not be a part of the same
network. Talk with your provider and arrange for services to be done at a Baystate or
Baycare facility in order to receive the lowest costs.
How does it work when I receive care in different Network Tiers?

Services from any in-network tier (tiers 1-2) count towards all tiers’ deductibles, regardless of which in-
network tier was used. Out-of-network services only count towards out-of-network deductibles, except for
emergency care services, which are covered at the Tier 1 Baystate and Baycare level.
What if I have a dependent who lives out of area?
If a covered dependent lives out-of-state, emergency care will always be covered at the in-network level, but all
other services will be covered according to the network tier used. All dependents attending school out-of-area,
with preauthorization, are covered at the Baystate/ Baycare copay level for non-routine office visits and services
How many Tiers do our Plans have?

Tier 1: Baystate/Baycare $
Services received by a Baystate or Baycare provider/facility will cost you the least • Lowest deductible
amount because Baystate is able to offer discounted rates on the health care • Lowest out-of-pocket
services we provide “in-house”. If you need a service that is not offered in Tier 1, or • maximum
if you prefer to use a service in another tier, you will need to pay that other tier’s • Lowest copay/coinsurance
deductibles and out-of-pocket expenses.
Tier 2: HNE / Extended Network* $$ • Moderate deductible

*For the HSA Medical and Advantage Plus PPO Medical, Tier 2 includes both the • Moderate out-of-pocket
Health New England and United network. maximum
• Moderate
For the Advantage Plus HMO Medical plan, Tier 2 is only the Health New England copay/coinsurance
network.
Tier 3: Out-of-Network $$$$ • Higher deductible

This is the most expensive tier because rates are not able to be • Higher out-of-pocket
negotiated with providers who are not in the network, and therefore • maximum
these providers/facilities charge full price for their services • Higher copay/coinsurance
Baystate Advantage Plus HMO Medical Plan only covers services in Tier 1 and Tier 2, unless a service is not available in-
network, then preapproval can be obtained to have the service covered out-of-network.
Rev. 8/23
Baystate Health: Health New England Members | Wellness Reimbursement Program
Support for your healthy lifestyle choices

It’s up to you to take charge of your health—but we can help! Want to lose weight? Get in shape?
The motivation is there, but how do you work it into the budget? That’s where we come in.
Want to start a fitness routine?
Why not join a fitness club or take fitness or wellness classes. Already a gym member or taking classes? Here are
some incentives to keep up the good work!
When you or a covered member of your family purchases a membership to any qualified health club or takes
qualified aerobic or wellness classes, Health New England will reimburse you up to $200 per individual plan
and $400 per family plan per calendar year.
Maybe you’d rather focus on eating well and maintaining a healthy weight.
Check out Health New England’s reimbursement for participating in weight loss programs such as Weight Watchers®,
Nutrisystem®, Noom, Keto, Medi-Weightloss® or other in-person/online/app-based programs. Health New England will
reimburse you or a covered family member up to $200 per individual plan and $400 per family plan per calendar year.
Do you have a child in a school or town sports program?
You may apply the Health New England wellness reimbursement to those activities as well.
Making healthy lifestyle choices doesn’t have to be hard—especially when you have Health New
England to help you!
Maximum reimbursement is $200 per individual plan and $400 per family plan (max. $200 per member) per
calendar year for combined Fitness activities and Weight Loss programs.
This reimbursement* may be applied to:

• Aerobic/wellness classes • Golf and ski tickets • School and town sports
• Athletic event registration fees • Mindfulness classes and apps • Diet-based subscription programs
• Bike shares • Noom, Nutrisystem and other such as Weight Watchers®
• Community supported agriculture weight loss programs • Wellness, fitness and weight
(CSA) or farm shares • Nutrition classes and apps loss apps
• Fitness equipment and devices • Personal trainer fees
(i.e., treadmill, workout videos, fitbit) • Qualifying fitness club memberships
* Exclusions may apply. Please check your membership materials for details, or contact Member Services at (800) 791-7944 if you need more information. Please note:
Reimbursement requests for a prior year must be received by Health New England no later than March 31.
See reverse for how to submit your reimbursement online.
COM 5413-0923
Rev: 9/15/23
Online Wellness Reimbursement Instructions
Submit your reimbursement request online

Submitting your Wellness Reimbursement request is simple to do, and it can all be done online.
1. Log into our secure Member Portal 3. Then click “Next Step” and fill out the online
at my.HealthNewEngland.org. form to complete your request. There is
If it’s your first time to the Member Portal, you will need to register first. nothing to mail in.
2. Select “Forms” from menu at the left of 4. For family plans, be sure to select the
the screen, and click on “Wellness appropriate dependent/member for whom you
Reimbursement Form.” are submitting the reimbursement request.
The images used above are only examples of the online submission process and may not appear exactly the same for all members.
Health New England complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. ATTENTION: If you speak any
language other than English, language assistance services, free of charge, are available to you. Call (413) 787-4004 or TTY 711. Health New England cumple con las leyes federales de derechos
civiles aplicables y no discrimina por motivos de raza, color, nacionalidad, edad, discapacidad o sexo. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia
lingüística. Llame al (413) 787-4004 o TTY 711. Health New England cumpre as leis de direitos civis federais aplicáveis e não exerce discriminação com base na raça, cor, nacionalidade, idade,
deficiência ou sexo. ATENÇÃO: Se fala português, encontram-se disponíveis serviços linguísticos, grátis. Ligue para (413) 787-4004 ou TTY 711.
COM 5413-0923
Rev: 9/15/23
Delta Dental PPOSM Plus Premier
Easy Access and Great Value – Your Delta Dental Networks

As a Delta Dental PPO Plus Premier subscriber, you have access to two of Delta Dental’s extensive national networks- Delta
Dental PPO, with more than 293,000 participating dentist locations and Delta Dental Premier, the largest dental network
in the country with more than 368,000 dentist locations. Three out of four dentists nationwide participate in one or both
of these networks.
You will enjoy the great benefits when you receive your dental care from a participating dentist in either the Delta Dental
PPO or Delta Dental Premier Networks.
• Both networks offer discounted fees and a no balance billing policy
• You will receive good value from Delta Dental Premier network dentists who generally accept discounted fees
• You will enjoy the greatest savings when visiting Delta Dental PPO network dentists due to even deeper discounts
• If you choose to receive services from a non-participating dentist, you will have higher out-of-pocket costs as the
Delta Dental contact rates and the no balance billing policy do not apply.
Simply visit www.deltadentalma.com to find a participating dentist in your area.
Baystate Health 2024 Rates Value Plan Choice Plan

Bi-Weekly Premium Rates
Individual $13.01 $23.00
Employee + Child $26.29 $48.36
Employee + Spouse $29.27 $51.75
Family $39.84 $74.16
Deductibles $25 per Individual/$75 $25 per Individual/$75 per Family
per Family
Calendar Year Max $1,000 per person $2,000 per person
All contributions are on a pre-tax basis per applicable law.
Learn more at deltadentalma.com Your Plan is administered by:

Visit the member area of www.deltadentalma.com to find plan
information, review eligibility status, check on claim status, access the
Delta Dental of Massachusetts
Member Guide or find a dentist. If you have any questions or need 465 Medford Street
additional information, you can call customer service at 1-800-872-0500. Boston, MA 02129
Additional Benefit Information

• Dependent Eligibility – Eligible dependents up to age 26
• Deductible is waived for periodontal cleanings
• This plan is eligible for Rollover Max. See the benefit guide for details.
• Ask your dentist to submit a pre-treatment estimate to Delta Dental for any procedure that exceeds $300. This will help you
estimate any out-of-pocket expenses you may incur and will confirm that the services are covered under your dental
coverage.
• Non-participating dentists (Out-of-Network) may balance bill. Subscribers are responsible for the difference between the non-
participating maximum plan allowance and the full fee charged by the dentist.
The information on this coverage summary should be used only as a guideline for your dental benefits plan. For detailed information on your group’s plan,
riders, terms and conditions, or limitations and exclusions, refer to your plan’s Subscriber Certificate, which is available through your benefits administrator.
Category/Procedure Qualifications Coinsurance
In-Network Out-Of Network
Value Choice Value Choice
Plan Plan Plan Plan
Diagnostic 100% 100% 100% 100%
Comprehensive Evaluation Once every 60 months.
Periodic Oral Exam Two times per calendar year.
Panoramic or Full Mouth X-rays Once every 60 months.
Bitewing X-rays Two times per calendar year.
Single Tooth X-rays As needed.
Preventive 100% 100% 100% 100%
Teeth Cleaning Two times per calendar year.
Fluoride Treatments Two times per calendar year for members under age 19.
Space Maintainers Required due to the premature loss of teeth. For members under age
14 and not for the replacement of primary or permanent anterior teeth.
Sealants Unrestored permanent molars, every 4 years per tooth for members
through age 15. Sealants also covered for members age 16 and up to
Restorative age 19 and a recent cavity and are at risk for decay. 80% 80% 80% 80%
Silver Fillings Once every 24 months per surface per tooth.
White Fillings (Front Teeth) Once every 24 months per surface per tooth.
Inlays and White Fillings (Back Once every 24 months per surface per tooth.
Teeth)
Protective Restorations Once per tooth.

Stainless Steel Crown Once every 24 months per tooth (on primary teeth only).
Oral Surgery 80% 80% 80% 80%
Extractions Once per tooth.
General Anesthesia General Anesthesia and IV sedation allowed with covered surgical
impacted wisdom teeth only.
Periodontics (natural teeth only) 80% 80% 80% 80%
Periodontal Surgery One surgical procedure per quadrant in 36 months.
Scaling and Root Planing Once in 24 months, per quadrant. No more than 2 quadrants per date
of service.
Periodontal Cleaning Once every 3 months following active periodontal treatment. Not to be
100% 100% 100% 100%
combined with preventive cleanings.
80% 80% 80% 80%
Bone Grafts/GTR No more than 2 teeth per quadrant per 36 months on natural teeth.
Endodontics 80% 80% 80% 80%
Root Canal Treatment Once per tooth.
Root Canal Retreatment Once per tooth after 24 months have elapsed from initial treatment
Vital Pulpotomy Limited to deciduous teeth.
Prosthetic Maintenance 80% 80% 80% 80%
Bridge or Denture Repair Once per bridge/denture per 12 months, after 24 months of initial
insertion.
Crown or Onlay Repair Once per tooth per 12 months after 24 months of initial placement
Rebase or Reline of Dentures Once per denture within 36 months.
Recement of Crowns & Onlays, Once per crown, onlay or bridge.
Bridges
Emergency Dental Care 80% 80% 80% 80%
Palliative Treatment Three occurrences in 12 months.
Prosthodontics 50% 60% 50% 60%
Dentures Once within 60 months (age 16 and older).
Fixed Bridges Once within 60 months (age 16 and older).
Implants Once per 60 months per Implant. (Pre-estimate recommended).
Implant Abutments Once per implant only when surgical implant is benefited.
Major Restorative 50% 60% 50% 60%

Crowns or Inlay When teeth cannot be restored with regular fillings. Once within 60
months per tooth (age 12 and older).
Cast Posts/Buildups Once per tooth per 60 months only benefitted to retain a crown.
Orthodontics Covered at 60% of Maximum Plan Allowance charges to any age. $2,000 N/A 60% N/A 60%
separate LIFETIME maximum.
Delta Dental of Massachusetts

Baystate Health, Inc.
SU MMARY O F B E NE FIT S
VISION CARE IN-NETWORK OUT-OF-NETWORK
SERVICES MEMBER COST MEMBER REIMBURSEMENT
EXAM SERVICES
Exam $15 copay Up to $57
Retinal Imaging $15 copay Up to $10
40 %
OFF
additional complete pair
CONTACT LENS FIT AND FOLLOW-UP
Fit and Follow-up - Standard
Fit and Follow-up - Premium
$0 copay
$0 copay; 10% off retail price
less $55 allowance
Up to $40
Up to $40
of prescription eyeglasses FRAME

Frame $0 copay; 20% off balance Up to $140
over $175 allowance
20
LENSES
% Single Vision $5 copay Up to $70
OFF Bifocal $5 copay Up to $110
Trifocal $5 copay Up to $150
non-covered items, Lenticular 20% off retail price Not covered
including non- Progressive - Standard $5 copay Up to $120
Progressive - Premium $5 copay; 20% off retail price Up to $196
prescription sunglasses less $120 allowance
LENS OPTIONS
Anti Reflective Coating - Standard $45 Not covered
Anti Reflective Coating - Premium 20% off retail price Not covered
Polycarbonate - Standard $0 copay Up to $32
Find an eye doctor Scratch Coating - Standard Plastic $0 copay Up to $12
Tint - Solid and Gradient $15 Not covered
(Access Network) UV Treatment $15 Not covered
All Other Lens Options 20% off retail price Not covered
• 866.723.0596
CONTACT LENSES
• eyemed.com Contacts - Conventional $0 copay; 15% off balance over Up to $150
• EyeMed Members App $150 allowance
Contacts - Disposable $0 copay; 100% of balance Up to $150
• For LASIK, call over $150 allowance
Contacts - Medically Necessary $0 copay Up to $210
1.800.988.4221
OTHER
Heads Up Hearing Care from Amplifon Network Up to 64% off hearing aids; call Not covered
1.877.203.0675
You may have LASIK or PRK from U.S. Laser Network 15% off retail or 5% off promo Not covered
price; call 1.800.988.4221
additional benefits. FREQUENCY ALLOWED FREQUENCY - ALLOWED FREQUENCY - KIDS
Log into ADULTS
Exam Once every calendar year Once every calendar year
eyemed.com/member Lenses Once every calendar year Once every calendar year
to see all plans included Frame Once every calendar year Once every calendar year
Contact Lenses Once every calendar year Once every calendar year
with your benefits. Contact Lens Fit and Follow-up Once every calendar year Once every calendar year
(Plan allows the member to receive either contacts and frame, or frame and lens services.)
Fees charged by a Provider for services other than a covered benefit and any local, state or Federal taxes must be paid in full by the Insured Person to the Provider. Such fees, taxes or
materials are not covered under the Policy. Allowances provide no remaining balance for future use within the same Benefit Frequency. Some provisions, benefits, exclusions or
limitations listed herein may vary by state. No benefits will be paid for services or materials connected with or charges arising from: medical or surgical treatment, services or supplies
for the treatment of the eye, eyes or supporting structures; Refraction, when not provided as part of a Comprehensive Eye Examination; services provided as a result of any Workers'
Compensation law, or similar legislation, or required by any governmental agency or program whether federal, state or subdivisions thereof; orthoptic or vision training, subnormal
vision aids and any associated supplemental testing; Aniseikonic lenses; any Vision Examination or any corrective Vision Materials required by a Policyholder as a condition of
employment; safety eyewear; solutions, cleaning products or frame cases; non-prescription sunglasses; plano (non-prescription) lenses; plano (non-prescription) contact lenses; two
pair of glasses in lieu of bifocals; electronic vision devices; services rendered after the date an Insured Person ceases to be covered under the Policy, except when Vision Materials
ordered before coverage ended are delivered, and the services rendered to the Insured Person are within 31 days from the date of such order; lost or broken lenses, frames, glasses, or
contact lenses that are replaced before the next Benefit Frequency when Vision Materials would next become available. This is a snapshot of your benefits. The Certificate of Insurance
is on file with your employer. Member receives a 20% discount on items not covered by the plan at In-Network locations. Discount does not apply to Provider's professional services or
contact lenses. Plan discounts cannot be combined with any other discounts or promotional offers. In certain states members may be required to pay the full retail rate and not the
negotiated discount rate with certain participating providers. Please see the online provider locator to determine which participating providers have agreed to the discounted rate.
Discounts on vision materials may not be applicable to certain manufacturers' products. The Plan reserves the right to make changes to the products on each tier and to the member
out-of-pocket costs. Fixed tier pricing is reflective of brands at the listed product level. All providers are not required to carry all brands at all levels. Services and amounts listed above
are subject to change at any time. Discounts are not insured benefits. Underwritten by Fidelity Security Life Insurance Company of Kansas City, Missouri, Policy number VC-19, form
number M-9083, or Policy number VC-146, form number M-9184, in New York underwritten by Fidelity Security Life Insurance Company of New York, Policy Number VCN-1, form
number MN-1, or Policy Number VCN-19, form number MN-28.
Ready to live
your best
EyeMed life?
There’s so much more to your vision
benefits than copays and coverage. Get
ready to see the good stuff for yourself.
Your network is the place to start

ee who you want, when you want. You have
S
thousands of providers to choose from —
independent eye doctors, your favorite retail
stores, even online options.
Keep your eyes open for extra discounts

embers already save an average 71% off retail
M
using their EyeMed benefits,1 but our long list of
special offers takes benefits even further.
Remember, you’re never alone

e’re always here to help you use your benefits
W
like a pro. Stay in-the-know with text alerts or
healthy vision resources from the experts. If it
can make benefits easier for you, we do it.
Based on weighted average of sample transactions; EyeMed Insight

1
network/$10 exam copay/$10 materials copay/$120 frame or contact

lens allowance.
Create a member account

at eyemed.com
Everything is right there in one spot. Check claims and benefits, see
special offers and find an eye doctor — search for one with the hours,
location and brands you want. For maximum mobility, try the EyeMed
Members App (Google Play or App Store).
PDF-2004-M-377
Short-Term Disability (STD) Plan
For elections effective January 1, 2024
For Baystate Health Employees

ELIGIBILITY
- All active benefits eligible employees who are Entity Presidents, BMC Residents and BMP
physicians
- All active benefits eligible employees excluding BVNAH Union, BFMC Union employees,
Baystate Noble Union and Non-Union employees, BMP Physicians, Department Chairs and
Senior Vice Presidents
WHAT IS SHORT-TERM DISABILITY ForShort

Baystate MedicFor
Term Disability Baystate
coverage (STD) Medical
protects against Practices
loss of income Physicians
if you become disabled and
COVERAGE? are unable to work due to your own illness or non-occupational injury.
al Practices Physicians
HOW MUCH INCOME REPLACEMENT Baystate provides income replacement equal to 60% of your weekly base pay at no cost to
COVERAGE DO I GET? you.
You may be eligible to purchase an extra 10% or 20% of income replacement, for a total
effective income replacement of 70% or 80% respectively of your weekly base pay.
Depending on your income level, you may be eligible for additional income replacement
under Paid Medical Leave and may not need to enroll in this additional STD benefit. Please
review your open enrollment materials carefully for more information on PFML.
You may be able to supplement your STD benefit with Extended Illness Bank (EIB), PTO, and
or ETO based on your accrual plan.
WAITING PERIOD Entity Presidents, BMC Residents and BMP physicians: None
All other and All active full-time and part-time employees: First of the month following 90
days of continuous service
ELIMINATION PERIOD Injury: None Sickness: 7 days
MAXIMUM WEEKLY BENEFIT 60% Plan: $3,500 per week

70% or 80% Plan: $7,500 per week
MAXIMUM BENEFIT DURATION Twenty (20) weeks
DEFINITION OF DISABILITY You are disabled when we determine that:

• you are unable to perform one or more of the material and substantial duties of your own
job due solely to your illness or injury;
• you are under the regular care of a physician;
• you are unable to earn 80% of your covered weekly earnings due to the same illness or
injury.
CLAIM ADMINISTRATOR Administered by Aflac
OTHER INCOME OFFSETS Paid State Leave and Company Leave benefits are considered income offsets
The terms and conditions of coverage are detailed in the summary plan description (SPD) as provided by Baystate. If there
are any differences between the terms and conditions of this summary and the SPD provided to you, the SPD will govern.
Long-Term Disability (LTD) Insurance
Resident Physicians and Pharmacy Residents
What is Long-Term Disability Long Term Disability (LTD) insurance protects against loss of income if disabled
and unable to work in your own occupation. In the event you become ill or injured
and cannot work for 140 days or more, at no cost to you, Baystate provides 60% of
your annual base pay
Eligibility for Coverage All full-time active employees who are resident physicians and Pharmacy
Residents who are citizens or legal residents of the United States or its
territories, excluding temporary, leased or seasonal employees
Eligibility Full -time resident physicians and pharmacy residents working a minimum of 40
hours a week, excluding on-call hours
Percentage of Covered Earnings Baystate pays 60% of your annual base pay, which is your annual salary
Maximum Benefit Period If date of disability prior to age 63, payable to retirement age or 48 months, if
greater. Beyond age 63, see plan policy
Waiting Period None
Waiver of Premium Yes, while receiving a monthly LTD benefit
Maximum Monthly Benefit $5,000 per month
Insurance Carrier Aflac
Elimination Period 20 weeks
Substance Abuse, Mental Health 24 months
Benefit Limit
Other Income Offsets Social Security and Pension Benefits
Pre-Existing Condition Limit 3 months prior to effective date –received treatment; 3 months treatment free
after the effective date; 12 months insured –all claims covered
This summary is not a contract of insurance. The terms and conditions of coverage are detailed in the policy as issued by the carrier. If
there are any differences between the terms and conditions of this summary and the policy issued to you, the policy will govern. The
policy is governed by the laws of the state in which it is delivered. Certain terms or provisions may be different as required by the laws
of that state.
Life Insurance
For Baystate Health

Employees
WHAT IS LIFE INSURANCE? Life insurance helps provide financial protection for your loved ones in the event of your
passing. At no cost to you, Baystate provides full-time and part-time employees with an
amount of Basic Life insurance equal to your annual earnings, rounded to the next higher
$1,000. In addition, you also have the option to purchase Supplemental Life Insurance
and dependent life insurance.
COST OF ADDITIONAL SUPPLEMENTAL
Upon enrollment in the system, your rates will automatically be calculated based on
LIFE INSURANCE COVERAGE your salary and age.
COVERAGE SCHEDULE Employee supplemental life insurance benefit: annual earnings rounded to the next
highest $1000, times one, two, three, four, or five (1,2,3,4,5) not to exceed a
combined maximum of $1,500,000
BASIC LIFE AND AD&D AMOUNTS You will be covered one times (1X) your annual salary rounded to the next higher $1000
subject to a maximum of $500,000 for Basic Life and an equal amount of Basic AD&D
coverage
BASIC LIFE MAXIMUM AMOUNT
$500,000
GUARANTEED ISSUE AMOUNT $500,000
ELIGIBILITY FOR COVERAGE* All full-time active employees who are working a minimum of 30 hours per week and all
part time employees and part time physicians working a minimum of 16 hours per week.
Baystate Home Health part- time union and part-time non-union employees are not eligible
for the employer paid portion of this benefit.
INSURANCE CARRIER
Continental American Insurance Company (CAIC-Aflac)
COVERAGE EFFECTIVE DATE Eligiblefor coverage on the firstof a month after you enter an eligible class
WHEN DOES COVERAGE END Coverage ends at the end of the month in which youremployment with Baystate
Health terminates for any reason
PORTABILITY AND CONVERSION RIGHTS AND
CONVERSION RIGHTS Life coverage is bothPortable and/or Convertible, AD&D is Convertible
COVERAGE REDUCTION DUE TO AGE

Coverage reduces to 67% of the original amount on turning age 65
ACCELERATED DEATH BENEFIT (ADB)
75% to a maximum of $500,000
TERMINAL ILLNESS LIFE EXPECTANCY 24 months
ACCIDENTAL DEATH & DISMEMBERMENT
(AD&D) Included. The amount of AD&D coverage will equal the amount of yourBasic Life
coverage, and the amount of any Supplemental Life coverage you elect.
This summary is not a contract of insurance. The terms and conditions of coverage are detailed in the policy as issued by the carrier. If
there are any differences between the terms and conditions of this summary and the policy issued to you, the policy will govern. The
policy is governed by the laws of the state in which it is delivered. Certain terms or provisions maybe different as required by the laws
of that state.
Life Insurance
Baystate Health Employees

WHAT IS LIFE INSURANCE? Life insurance helps provide financial protection for your loved ones in the event of your
passing. The Supplemental Life Insurance plan does not provide any cash value.
HOW MUCH LIFE INSURANCE CAN I BUY? You: Active, full-time, and part-time employees can buy Supplemental Life in amounts
equal to your Annual Earnings, rounded to the next higher $1,000, times one, two,
three, four, or five (1X – 5X), to a maximum of $300,000 FT and PT employees,
$500,000 Physicians, Managers and above
Your Spouse: You may enroll your spouse in Supplemental Life coverage in $10,000
increments up to the maximum of $100,000.
Your dependent child(ren): You may enroll your dependent child(ren) in Supplemental
Life coverage in $5,000 increments up to $20,000, not to exceed your (employee)
coverage amount. Covering multiple children costs no more than covering one child.
GUARANTEED ISSUE AMOUNT You: New hires and newly eligible employees may elect up to the lesser of five times
(5X) your annual earnings or $300,000 FT and PT Employees, or $500,000 Physicians
Managers and above of Supplemental Life coverage without having to satisfy the
Evidence of Insurability (EOI) process. If you elect more than the Guaranteed Issue
amount, Aflac will send you an online link to questions about your health history to be
approved for the additional coverage.
Your Spouse and/or dependent child(ren): If you elect more than $30,000 of
Supplemental Life coverage for your spouse, he or she will need to satisfy the EOI
process for the additional coverage to become effective. EOI is not needed to cover a
dependent child in Supplemental Life coverage.
ELIGIBILITY FOR COVERAGE All full-time active employees who are working a minimum of 30 hours per week
All part-time active employees who are working a minimum of 16 hours per week
COST OF SUPPLEMENTAL LIFE COVERAGE When you enroll in the plan, your rates will automatically calculate based on your salary
and age.
INSURANCE CARRIER Continental American Insurance Company (CAIC-Aflac)
COVERAGE EFFECTIVE DATE You are eligible for coverage on the first of a month after you enter an eligible class
If you already have Supplemental Life coverage, your coverage with Aflac will become
effective on January 1, 2024, provided you are actively at work on or as of that date.
WHEN DOES COVERAGE END Coverage ends at the end of the month in which your employment with Baystate Health
terminates for any reason
PORTABILITY AND CONVERSION Life coverage is both Portable and/or Convertible
COVERAGE REDUCTION DUE TO AGE Coverage reduces to 67% of the original amount on turning age 65
ACCELERATED DEATH BENEFIT (ADB) 75% to a maximum of $500,000
TERMINAL ILLNESS LIFE EXPECTANCY 24 months
ACCIDENTAL DEATH & DISMEMBERMENT

Included.
(AD&D)
Thissummary is not a contractof insurance. The terms and conditions of coverage are detailed in the policy as issued by the carrier. If there
are any differences between the terms and conditions of this summary and the policy issued to you, the policy will govern. The policy is
governed by the lawsof the statein which it is delivered. Certain terms or provisions may be different asrequired by the laws of that
state.
BenefitsPlus
Program
Solutions that fit your lifestyle
and your budget
Enroll within 30 days of job hire/transfer
Critical Illness Insurance Accident Insurance Hospital Confinement

Indemnity Insurance
Pays a lump-sum cash benefit Provides cash benefits for
directly to you to help cover out- out-of-pocket expenses Pays a lump sum each day you’re
of-pocket expenses associated associated with a covered in the hospital—for any reason.
with a covered critical illness.1,2 accident and can help protect That money can help offset the
This is not a replacement for medical insurance. hard-earned savings should an hospital bill, take care of day-to-
Available to all benefits-eligible employees. accident occur.1,2 day expenses, or pay for anything
This is not a replacement for medical insurance.
you need.1,2
Available to all benefits-eligible employees. This is not a replacement for medical insurance.
Available to all benefits-eligible employees.
Legal Insurance Plan Whole Life Insurance

Getting legal help shouldn’t be difficult Designed to provide a base of life insurance
or unaffordable. A legal plan provides coverage for a lifetime. It offers life insurance
professional legal counsel for everyday protection, tax deferred cash accumulation
personal legal needs, at a fraction of a (based on current tax laws) and cash value loan
lawyer’s standard rate. privileges—all in one policy.5
Available to all benefits-eligible employees. Ability to enroll in or upgrade whole life coverage is strictly limited to
annual enrollment.
Available to all benefits-eligible employees.
Make the most of your

benefits. Call or go online 1-855-290-5661 Workday > Benefits
to learn more. and select the BenefitsPlus tile
Enroll Year-Round
Auto and Home Program Identity Theft

Protection Services
Save on your auto, home and renters
insurance by comparison-shopping You get award-winning identity theft
coverages, rates and discounts from five protection to help better protect your
of the leading auto and home insurance and your family’s financial and personal
companies in the nation.3,4 information.
Available to all employees, including per diem employees. Available to all employees, including per diem employees.
Pet Insurance and PerkSpot Discount 529 College

Pet Prescription Center Saving Plan
Discount Plan A 529 college savings plan
A one-stop online shop
Take advantage of two-way where you can save is designed to help families
pet protection: Nationwide® money with exclusive set aside funds for education
pet insurance and PetPlus discounts at many of your expenses, offering significant
Prescription and Product favorite national and local tax benefits and an
Discount Plan. You can merchants! It’s completely exceptional degree of control
choose to enroll in one plan free and optimized for use and flexibility.
Available to all employees, including per
or both. on any device: desktops, diem employees.
Available to all employees, including per tablets and phones.
diem employees.
Available to all employees, including per
diem employees.
Make the most of your

benefits. Call or go online 1-855-290-5661 Workday > Benefits
and select the BenefitsPlus tile
to learn more.
¹See the product brochure, certificate of coverage and any applicable riders for the definition of covered facilities, along with complete provisions, exclusions and limitations.
2
Critical Illness, Accident, and Hospital Confinement Indemnity Insurance are limited benefit policies. These are not health insurance and do not satisfy the requirement of minimum essential coverage under the Affordable Care
Act. These insurances are designed to complement your medical insurance coverage, not replace it.
3
Home insurance may not be available from all carriers in all states and may not be offered in this program.
4
Employee discounts are not available from all carriers and only available to those who qualify. Coverages, discounts and billing options are subject to state availability, individual qualifications, and/or the insuring company’s
underwriting guidelines. Individual savings may vary and are not guaranteed.
5
This communication is not intended or written to be used, and cannot be used by the recipient or any other person, for the purpose of avoiding any tax penalties that may be imposed on such person, and cannot be used or
referred to, in promoting, marketing, or recommending to another party any transactions or matters addressed herein.
Accident, Critical Illness and Hospital Confinement Indemnity Insurance are issued by ReliaStar Life Insurance Company (Minneapolis, MN), a member of the Voya® family of companies. Policy provisions and product availability
may vary by state.
Program Offered and Administered by Mercer Health & Benefits Administration LLC
In CA d/b/a Mercer Health & Benefits Insurance Services LLC AR Insurance License #100102691 CA Insurance License #0G39709
102597 M8060 (11/22) Copyright 2022 Mercer LLC. All rights reserved.
Benefits Enrollment: Guide for Decision Making
Based on your anticipated needs for the upcoming year, use this checklist to help you decide what benefits you should enroll in.
Check off the benefit options that you are ready to explore.
Insurance Baystate Paid Portion Employee Paid Portion What are your anticipated healthcare
Benefit and Coverage Options needs for the upcoming year?
Medical, Rx, Dental & Vision Insurance: Provides access to healthcare, while protecting you financially from paying for the full cost of services.
Advantage Plus HMO Plan: Advantage Plus HMO Plan: You pay about 18% of your If all your medical service needs are within Tier 1 and 2,
Medical & Baystate pays about 82% of total insurance premium. There is no deductible when you then the Advantage Plus HMO Plan may be the most cost-
your insurance premium. use tier 1 services. effective option. However, if you also use medical
Pharmacy Advantage Plus PPO Plan: Advantage Plus PPO Plan: You pay about 22% of your services in Tier 3,then the Advantage Plus PPO Plan may
Baystate pays about 78% of total insurance premium. There is no deductible when you make the most sense.
your insurance premium. use tier 1 services.
HSA Plan: Baystate pays HSA Plan: You pay about 12% of your total insurance The HSA plan is a high deductible health plan; therefore, a
about 88% of your premium. Aside from 100% covered preventive care, there deducible will always apply (until met). However, the
insurance premium. is always a deductible for services in the HSA plan, however premiums are lowest in this plan and the money you save
the plan comes with a Health Savings Account, which you in your Health Savings Account is yours to keep forever
can contribute tax free money to help pay for expenses. BH and can be invested for future medical spending.
also provides an annual deposit of $400 (individual) and
$800 (family). Baystate makes a total annual contribution
of $500 for full-time, individuals earning less than $35,000
and $1,000 for full-time employees who earn less than
$75,000 enrolled in the family coverage.
Flexible FSAs are 100% employee- Health Care FSA – used for qualified medical, dental, The money you put into an FSA is pre-tax and therefore
Spending funded and allow you to vision, deductibles, co-pays and coinsurance (non-HSA plan not subject to federal, state and Social Security taxes. If
set aside pre-tax money members only). you accurately estimate what your out-of-pocket annual
Accounts from your paycheck to help Limited Purpose FSA – used for qualified dental and vision spend is, an FSA can save you money. However, only $610
(FSA) pay for out-of-pocket expenses, for those enrolled in the HSA plan. of the health care and limited purpose FSA’s roll into the
eligible medical and Dependent Care FSA – used for care expenses like day next plan year if you elect to continue it again. And you
dependent care expenses. care, day camp, nursery school and eldercare expenses cannot rollover any funds from a dependent care FSA.
incurred while at work.
Dental You receive an employer You pay 100% of the premium cost of insurance and the Aside from an annual cleaning, do you anticipate any
discount which reduces dental plan covers 50%-100% of all eligible dental services dental procedures needed? Orthodontics? Major
your premium and out-of- up to the annual maximum, depending on whether you restorative work, crowns? Choose the coverage option
pocket expenses. choose the Value or Choice Plan. that best suits your needs.
Vision You receive an employer You pay 100% of the cost of the insurance and the plan If you only need 1 annual preventive eye exam, this is
discount which reduces covers the majority of service needs. already included in your Baystate medical plan. If you
your premium and out-of- need more than this or have other vision needs, consider
pocket expenses. vision insurance.
Insurance Baystate Paid Portion Employee Paid Portion and What are your anticipated healthcare
Benefit Coverage Options needs for the upcoming year?
+
Disability Insurance: Pays a portion of your salary, for a specified duration, if you are ill/injured off the job, and cannot perform your job duties.
Short Term BH pays 60% of your You can purchase additional 10% or 20% STD buy-up If you would not meet your personal financial
Disability annual base earnings up to insurance to replace 70% or 80% of your regular pay while commitments on 60% of your earnings, consider
20 weeks. on leave. purchasing STD buy-up insurance, and/or use your
NEW FEATUREA If you still have an Extended Illness Bank (EIB), you can Extended Illness Bank (EIB) to supplement up to 90%
supplement your short-term disability benefits (including of your pay. Personal Time can also be used to
buy-up) up to 90% wage replacement. replace income up to 100%.
Paid Medical Leave – Be sure you understand how state- If you earn less than $45,000, you may not need to
specific leave programs may impact your need for STD purchase STD buy-up insurance.
buy-up.
Long Term BH pays 50% of your You have the option to purchase an additional 10% or If you would not be able to meet your household
Disability annual eligible earnings 20% LTD buy-up insurance to replace 60% or 70% of your financial commitment on 50% of your earnings,
following 20 weeks of regular pay while on leave. consider purchasing 10% or 20% LTD buy-up
short-term disability. insurance.
Life Insurance: Provides your beneficiaries financial protection in the event of your passing. Term Life Insurance applies while you’re employed.
Whole Life insurance covers you beyond BH employment and is available for purchase for self, spouse and children- see BenefitsPlus below.
Term Life BH provides your You can purchase additional term life insurance coverage Consider what amount of money your beneficiaries
Insurance beneficiaries one lump in amounts of 1 to 5 years of your annual earnings. You would need to maintain their lifestyle and live
sum payment of your can also purchase coverage for your spouse and children. comfortably, without depleting existing assets.
annual eligible earnings.
Designate a Beneficiary – In order for your loved ones to receive life insurance benefits, you must ensure you have designated a beneficiary in
Workday (for life insurance ) and Fidelity NetBenefits (for your retirement plan) and keep this information up to date.
Retirement Account - While not required during Open Enrollment, an annual review of your retirement contribution and beneficiary designation
makes good financial sense.
Workers’ Compensation - Baystate pays 60% of your earnings and medical expenses if you are injured or become ill in the course or scope of your
job. An employee cannot purchase Workers’ Compensation.
BenefitsPlus offers additional Personal Insurance Products (benefits available for purchase at discounted employer rates.)
❑ Accident Insurance* ❑ Critical Illness Insurance* ❑ Hospital Indemnity Insurance* ❑ Pet Insurance
❑ Legal Insurance* ❑ Auto and Home Insurance ❑ Identity Protection Insurance ❑ Whole Life Insurance*
*Only available during benefits open enrollment.
This information applies to full time non-union team members and is a guide/summary only. For part time and position Rev
specific information and for full plan details visit, The Hub>Quick Links>Benefits>Legal Plan Notices 9/2023
Baystate Health Inc. Retirement Plan Highlights
Welcome to the Baystate Health Inc. Retirement Plan (the Plan)! It’s easy to get caught up in the present, but it’s
also important to look ahead. Start investing in your future—and yourself—with help from the Plan and Fidelity®.
Enroll Now!
If you haven’t joined the Plan, you can enroll on Fidelity NetBenefits® at www.netbenefits.com/atwork or call a
Fidelity representative at 800-343-0860.
To use the EasyEnroll feature and enroll in the Plan in just 60 seconds, go to www.netbenefits.com/easy.
Key Features of Your Baystate Health Inc, Retirement Plan

Eligibility You are immediately eligible and can enroll in the Plan at any time.
If you do not enroll in the Plan or elect to opt out after 35 days, you will be automatically enrolled
at a 3% pre-tax contribution rate. Your contributions will be invested in the Plan’s default fund,
one of the Vanguard Target Retirement Funds. Target Date Funds are an asset mix of stocks,
bonds and other investments that automatically becomes more conservative as the fund
Automatic approaches its target retirement date and beyond. Principal invested is not guaranteed.
Enrollment We encourage you to choose a contribution rate and investment options that are appropriate for
you. If you don’t want to contribute to the Plan, you must change your contribution rate to 0%.
You can change your contribution rate, select other available investment options, or opt out of
the Plan at any time.
You can contribute from 1–100% of your eligible base pay as pre-tax or Roth contributions, or a
combination, up to the annual IRS dollar limits.
Your Contributions A Roth contribution to your Plan allows you to make after-tax contributions and take any
associated earnings completely tax-free at retirement, as long as the distribution is a qualified
one. A qualified distribution, in this case, is one that is taken at least five tax years after your first
Roth 401(k) contribution and after you have attained age 59½, become disabled, or die.
You can choose to increase your retirement savings plan contributions automatically each year
Annual Increase through the Annual Increase Program. You choose the amount of the annual increase from 1 to
Program 3% and the effective date. You may opt out at any time.
It’s important to designate a beneficiary for your Plan account. Log on to NetBenefits® at
Online Beneficiary www.netbenefits.com/atwork to designate your beneficiary online.
Designation
Baystate Health will immediately match 50% of the first 4% of pre-tax and/or Roth contributions
you make to the Plan.
Baystate Health also contributes an annual contribution to your account provided you have
worked at least 1,000 hours in the year and are employed on December 31.
Employer
Contributions The annual contribution is based on your years of service:
Less than 11 Years of Service = 3 %
11-20 Years of Service = 4%
21 or More = 5%.
You are always 100% vested in your own contributions to your Plan account, as well as any
earnings on them.
Contributions from Baystate Health will be fully vested when you have completed 3 years of
service. One year of service is credited for each year in which you work at least 1,000 hours.
Vesting
Years of Service Vested %
1 0%
2 0%
3 or more 100%
The Plan offers you a range of options to help you meet your investment goals.
You can select a mix of investment options that best suits your goals, time horizon, and risk
Investments tolerance. Descriptions of the Plan’s investment options and their performance are available
online at www.netbenefits.com/atwork.
Although your Plan account is intended for the future, you may borrow from your account for
Loans any reason. Log on to NetBenefits for more details or to request a loan.
Withdrawals from the Plan are generally permitted when you attain age 59½, terminate your
Withdrawals employment, retire, become permanently disabled, or have severe financial hardship as defined
by the Plan. Refer to the Summary Plan Description or call Fidelity for more details.
You are permitted to roll over eligible pre-tax contributions from another 401(k), 403(b), or
governmental 457(b) retirement plan account, or eligible pre-tax contributions from conduit or
Rollovers non-conduit individual retirement accounts (IRAs). Rollovers from Roth sources are also
allowed. Be sure to consider all your available options and the applicable fees and features of
each before moving your retirement assets.
Fidelity® Take the time and stress out of managing your own investments with access to a team of
professionals that will help you create a plan and stay on track to retirement.
Personalized
Planning & Advice* This service provides advisory services for a fee which is paid from your account.
Fidelity Workplace Financial Consultants are available and can help with enrollment, asset
One-on-one allocation, retirement planning and other questions you have about the Plan. Call 800-642-7131
consultations to schedule a complimentary appointment or register online at fidelity.com/schedule.
Accessing your account
Access your Plan account online at www.netbenefits.com/atwork. Download the NetBenefits® app to
access your account on your mobile device.
Fidelity is here to help! If you have questions, call 800-343-0860 Monday through Friday, 8:30 a.m. to
midnight Eastern time (excluding most holidays). You can also use the automated voice response system,
virtually 24 hours, 7 days a week.
Para español, llame al 800-587-5282.
Before investing in any mutual fund, consider the investment objectives, risks, charges, and expenses.
Contact Fidelity for a prospectus or, if available, a summary prospectus containing this information.
Read it carefully.
Investing involves risk, including risk of loss.

This document provides only a summary of the main features of the Baystate Health Inc, Retirement Plan and the Plan Document will govern in the
event of discrepancies.
*Fidelity® Personalized Planning & Advice at Work is a service of Fidelity Personal and Workplace Advisors LLC and Strategic Advisers LLC. Both are
registered investment advisers, are Fidelity Investments companies and may be referred to as "Fidelity," "we," or "our" within. For more information,
refer to the Terms and Conditions of the Program. When used herein, Fidelity Personalized Planning & Advice refers exclusively to Fidelity
Personalized Planning & Advice at Work. This service provides advisory services for a fee.
Fidelity Brokerage Services LLC, Member NYSE, SIPC, 900 Salem Street, Smithfield, RI 02917
©2022. All rights reserved.
775330.34.36
Download the NetBenefits® mobile app.
Access all your Fidelity® workplace accounts — anytime, anywhere.*
ALERTS
Get messages
about timely actions
to take within your
account.
VIEW ACT PLAN LEARN

Review account balances, Change contributions See how much you Access articles,
investments, your or investments, may need in retirement videos, podcasts,
personal rate of return, update your profile and get your Fidelity and interactive tools.
next steps, and more. or beneficiaries, send Retirement ScoreSM.1
paperwork, and more.
Fidelity.com/go/NetBenefitsapp
Download the NetBenefits® app today

for an iPhone® or Android.
Investing involves risk, including risk of loss.

1
IMPORTANT: The projections or other information generated by Fidelity Retirement Score regarding the likelihood of various investment outcomes are
hypothetical in nature, do not reflect actual investment results, and are not guarantees of future results. Results may vary with each use and over time.
*System availability and response times may vary.
Screenshots are for illustrative purposes only.
iPhone, Apple, and the Apple logo are registered trademarks of Apple Inc. App Store is a registered service mark of Apple Inc.
Android and Google Play are registered trademarks of Google LLC.
Any third-party trademarks or service marks appearing herein are the property of their respective
owners. All other trademarks and service marks appearing herein are the property of FMR LLC or
an affiliated company and may be registered.
Fidelity Brokerage Services LLC, Member NYSE, SIPC, 900 Salem Street, Smithfield, RI 02917
© 2023 FMR LLC. All rights reserved.
669724.23.0 1.9585483.112 45674_07/0223
How to register for access to your account on
Fidelity NetBenefits® at www.netbenefits.com/atwork
If you have previously registered with Fidelity.com, NetBenefits®, or eWorkplace®, you do not need
to register again. Use your existing username and password to access your new account.
If you have not yet registered, use the instructions below to help you set up your workplace savings
account on NetBenefits.
New user registration 1

During the new user registration process, you may
be asked to take an additional security step to help
us authenticate your account.
1 Verify your identity
Enter information in the following required fields:

• Your first and last name
• Your date of birth
• Last four digits of your Social Security number
Select the Continue button.
2 Provide your contact information 2
Enter information in the following required fields:

• Personal email
• Phone type
• Phone number
• Read our electronic disclosure
Select the Continue button.
2
3 Set up your username
We require that you create a unique username.

• Use 8–15 characters, including at least two letters. 3
You may not use:
• Special characters or symbols
• Sequences (e.g., 12345 or 11111)
• Personal info (SSN, phone #, DOB) 4
4 Create a password
Your password protects your account from unauthorized users.

• Use 6–20 characters.
• Use at least one number .
• Letters are case sensitive
For illustrative purposes only.
You may not use:
• Special characters except for ”#&*<>{}’[]”
• Sequences (e.g., 12345 or 11111)
• Personal info (SSN, phone #, DOB)
• A password you've used before
After confirming your password, select Continue .
5 New user registration confirmed 5

You have successfully registered. If you have other accounts
through Fidelity.com, NetBenefits, or eWorkplace, your new
login information applies to these accounts, as well as to
accessing your account by phone.
Fidelity uses the contact information you provide to send you important communications about your benefits, as well
as timely service-related and legal notifications, including messages about educational and new service offerings.
Please be assured that this information is used only to communicate with you regarding your benefits with Fidelity
and will not be shared with any other parties. Fidelity Investments has always been committed to maintaining the
confidentiality, integrity, and security of personal information entrusted to us by current and prospective customers.
6 Begin using NetBenefits
6
After you log in with your new account username and password,
and update your email address, email preferences, and mobile
phone number, you can:
• Enroll in your plan, if you haven’t already
• Check your account balances
• Update how much you set aside to save from your paycheck
• Make changes to your investments
• Visit the Planning & Guidance Center and set up important
financial goals, such as saving for retirement, college, and
other personal goals (e.g., buying a home)
• Access educational resources in the NetBenefits Library to
improve your financial know-how on a wide range of topics
(Social Security, loans, budgeting, etc.)
For illustrative purposes only.
7 Select a security question

7
Once you log in, you will be prompted to set a security
question in case you ever forget your password.
You can reset it after Fidelity verifies your identity using
your new or updated security question and answer.
Pick a security question you can easily answer and
enter your answer.
• Answers must be between 3 and 31 characters

• Answers are not case sensitive
Select Submit.
Need help setting up your account?Call

your Plan’s toll-free number.
800-343-0860
Your Benefits: Age-Related Considerations
This document outlines the important changes that occur within the Baystate Health Benefit plans as you reach certain ages. If you have
questions, call HRAnswers at 413-794-4747. For additional financial resources & retirement information, see The Hub>Quick Links>Benefits.
Your Age Benefit Change to Benefit Based on Age

See chart Long Term Disability Age at Disability / Maximum Payment Period
Insurance • Age 61 or less / up to age 65 • Age 64 / 30 months • Age 67 / 18 months
• Age 62 / 42 months • Age 65 / 24 months • Age 68 / 15 months
• Age 63 / 36 months • Age 66 / 21 months • Age 69 and over / 12 months
50 yrs. 403(b) Retirement Plan Federal rules permit “catch-up” contribution to 403(b) if an individual is 50 or older, allowing an increase in annual
55 yrs.
s
contributions up to an additional $7,500 per year.
Health Savings Account Federal rules permit "catch-up" contributions to Health Savings Accounts (HSA) if an individual is 55 or older,
(HSA) allowing an increase in annual contributions up to an additional $1,000 per year.
55 yrs. Retirement Account (DB Once you terminate your employment, you can generally elect to receive payment any time after you reach age 55.
Pension)
59 ½ yrs. 403(b) Retirement Plan Once you reach age 59½, you can make an in-service withdrawal of your voluntary contributions and investment
earnings, as well as any of the vested matching, core, or transition contributions that have been credited to your
account without the IRS rules imposed on financial withdrawals (10% early withdrawal tax).
64 yrs. Health Savings Account The IRS doesn’t allow company or employee contributions to an HSA at age 65. If you enroll in a Medicare plan at
(HSA) age 65, including Part A, B, C, or D, you must ensure that all employer and employee contributions into your HSA
cease. Since Medicare eligibility begins 3 months before you turn 65, your HSA employer and employee
contributions must end 3 months before you turn age 65. Contact HRAnswers at 413-794-4747 or
HRAnswers@baystatehealth.org in order to stop your HSA employer and employee contributions. If you are
currently enrolled in the HSA, contact Medicare in the year in which you are retiring to determine if a refund is
required.
65 yrs. Life Insurance In the pay period during which your birthday falls, if you have reached age 65, your amount of life insurance will be
67% of the amount of life insurance you had prior to age 65. The supplemental life insurance premium rates
increase at certain age intervals, including at age 65.
Your Age Benefit Change to Benefit Based on Age
65 yrs. Retirement If you terminate employment, you must start receiving your defined benefit payment(s) when you reach age 65.
Account (DB
Pension)
65 yrs. Medicare – I have employer coverage and I am turning 65 – If you have employer sponsored group health plan coverage (as defined by the
Parts A, B,C, IRS) and you are actively working you may be able to delay Part A and Part B and won’t have to pay a lifetime Medicare late
&D enrollment penalty if you enroll when your employer sponsored coverage ends. If you want to delay both Part A and Part B
coverage, you don’t need to do anything when you turn 65 as long as you do not begin receiving social security payments.
I am eligible for premium-free Part A - you can enroll in Part A at any time after you’re first eligible for Medicare. Your Part A
coverage will go back (retroactively) 6 months from when you sign up (but no earlier than the first month you’re eligible for
Medicare). If you aren't eligible for premium-free Part A, and you don't buy it when you're first eligible, you may have to pay a
penalty. The late enrollment penalty takes the standard premium amount and increases it by 10% for each full 12-month
period that you could have had Part B, but didn’t. The penalty does not apply while you are enrolled in employer-sponsored
coverage.
For example, if you were first eligible for Part B in July 2021, but didn’t enroll until January 2022, you’d have a 20% late
enrollment penalty. The standard premium amount would be increased by 20% for as long as you have Part B.
I am first eligible to enroll in Medicare at age 65 - The first time you can enroll is called your Initial Enrollment Period. Your 7-
month Initial Enrollment Period usually:
• Begins 3 months before the month you turn 65
• Includes the month you turn 65
• Ends 3 months after the month you turn 65
I don’t have employer coverage and I am over age 65 – Contact Medicare at 1-800-633-4227 and the SHINE Program at 413-
781-8800 two months before leaving Baystate to enroll in Medicare Part A, Part B, Part D, and Supplement, OR a Medicare
Advantage Plan (Part C).
Resources:
Medicare and You, Revised January 2022
73 yrs. 403(b) You cannot keep retirement funds in your 403(b) account indefinitely. You generally have to start taking withdrawals called
Required Required Minimum Distributions (RMDs) from your retirement plan account when you reach age 73 beginning January 1,
Minimum 2023, and are no longer working. You must take your first RMD generally by April 1 of the year following the later of the
Distribution calendar year in which you: reach age 73 or retire. For each subsequent year after your required beginning date, you must
withdraw your RMD by December 31. Rev. 6/28/2023
YOUR PARTNER IN WORK & LIFE
These programs and resources are designed to enhance the health, well-being and worklife balance of Baystate Health
employees and your loved ones. Most of our programs are provided to you at no-cost, unless otherwise noted.
Well-being Essentials
Well-being Essentials focuses on getting to the root cause of life’s challenges. Getting to your core emotional and essential needs will
offer new opportunities for you to bring your best self to life. Visit baystate.Kumanu.com to access the programs listed below.
New! Well-being Essentials Rewards – An important part of discovering and optimizing your well-being is the opportunity to be
rewarded for the time you spend learning, growing and improving the areas of your life that need your attention. The Well-being
Essentials Rewards program is designed to motivate you to explore and identify areas you want to work on, in order to set yourself
on a path to your best life. Beginning January 1, 2024, you will be eligible to participate in monthly challenges, with monthly payouts,
to continuously remind and reward you for the work you put into your self-care and overall well-being.
Resourceful - Customized resource center that offers in-house and community-based resources, personalized to meet individual
needs for things like financial assistance, transportation, childcare, housing, mental health, social connection, food access, and more.
Visit baystate.Kumanu.com to get started.
Purposeful - Build positive habits through powerful and simple activities designed to help you manage your emotions, have more
energy, strengthen relationships and bring your best to what matters most each day.
Personal Well-being
These resources are centered around your mental and physical health. Strong personal well-being helps you cope with life’s stressors,
maintain a positive outlook, have energy to do things you enjoy, and keeps you happy, healthy and safe.
Employee Assistance Program (EAP) – 24/7 confidential support from a licensed professional. Short-term therapy (6 sessions) at no-
cost for you and your family, available in-person or virtual. Call 800-888-6332 to schedule an appointment.
Marvin Teletherapy - Confidential teletherapy with nights & weekend appointments available. Visits are billed through your
insurance (no-cost for BH-HNE plan members). Therapists are specialty-trained to work with healthcare workers. Visit
meetmarvin.com/baystate to schedule an appointment.
Lifestyle Coaching – Trained coaches provide confidential and unbiased support, resources, and accountability to help you achieve
your lifestyle-related goals. Coaching calls are no-cost to you and your family. Call 800-888-6332 to schedule a session.
Healthy Sleep - Resources that can help you improve your quality and quantity of sleep and restore your energy.
Fitness – Resources include indoor/outdoor walking routes, self-guided videos, listings of fitness resources in your community.
Nutrition - Registered Dietitian appointments available through BH-HNE medical plan (up to 4 visits/year).
Financial Well-being
Money Coaching – Free and unlimited money coaching on any financial topic through My Secure Advantage. This expert team of
money coaches provide confidential, unbiased support for every stage of life. To schedule a session, call 888-724-2326 or visit
baystate.mysecureadvantage.com
Enhanced! Wellness Reimbursement - Effective January 1, 2024, spouses and dependents enrolled on your medical plan will also be
eligible for reimbursement! Individual plan members can receive up to $200 per calendar year and family plan members can receive
up to $400 total, per calendar year ($200 per individual on plan). Plus, we’ve added even more ways to get reimbursed, including
athletic event registration fees, bike shares, and school/town sport fees. Login to your HNE portal at my.healthnewengland.org and
select Forms.
Financial Well-being continued
Retirement Savings - Access to Baystate’s retirement plan and assistance from Fidelity to set up your retirement savings plan. Visit
www.netbenefits.com/atwork or call 800-343-0860. Fidelity Representatives can answer your questions Monday through Friday, 8:30
a.m. to midnight.
Tax-Advantaged Savings Accounts - Access to Healthcare Flexible Spending Accounts, Dependent Care Flexible Spending Accounts
and Health Savings Accounts.
Income Protection Benefits - Additional short- and long-term disability, life insurance, identity theft insurance & more available for
purchase.*
Legal Assistance - Access to a free 60-minute consultation with an attorney - 1 consult per legal topic per year. Call 800-888-6332 to
connect with an attorney. Legal insurance is also available for purchase, through MetLife.*
Onsite Banking and Credit Union Membership - Pioneer Valley Credit Union membership includes onsite banking (BMC), online
banking, free checking, low-rate loans, etc. Employees who work, reside or worship in Franklin county are eligible to join Franklin First
Credit Union.
PerkSpot Discount Center - Local and national discounts/promotions on hundreds of products and services. Start savings on
baystate.perkspot.com.
Massage Reimbursement - Up to two, 60-minute massage therapy visits per calendar year for BH-HNE plan members*. Login to your
HNE portal at my.healthnewengland.org and select Forms. *For HSA/High Deductible Health Plans — charges will apply towards your
deductible; reimbursement will only occur after your deductible has been met.
Home Buying Assistance - Through the Mark R. Tolosky Baystate Neighbors Program employees can receive up to $7,500 in
forgivable loans for a first-time home purchase in Springfield, Greenfield, Palmer, Ware, and Westfield. For information, visit The
Hub/My Baystate/Home Buying Assistance Program.
Enhanced! Caring for Colleagues - This program offers emergency assistance to employees who have experienced a sudden loss of
income, family crisis, or other unforeseen circumstance. The program will re-launch on January 1, 2024, and is funded by donations
made by Baystate Health, its employees, and the community. Up to $1,200 per calendar year is available to employees in need.
Work-Life Integration
New! Back-up Care Reimbursement Program - Baystate Health recognizes the challenges our working parents face when their
regular childcare arrangement falls through (due to ill caregiver or child, weather-related closures, etc.). Baystate Health now
provides $100 reimbursement per day, up to 5 days per year, for back-up care arranged on your own. Employees are responsible for
selecting an alternative caregiver (neighbor, family, friend, etc), the services provided, and any additional costs for care arranged.
Worklife Specialists - Personal Assistance Specialists available to research and find services, programs and information across the
broad spectrum of daily living needs- child care programs and activities, home repair and improvement, travel & vacation planning,
moving & relocation, purchasing a car, and more! Call 800-888-6332 to speak with a specialist.
Enhanced! Educational Assistance - Receive up to $5,250 (which is the maximum allowed by the IRS) reimbursement for expenses
incurred as part of an approved course of study at an accredited college, university, or technical school. . For more information,
review the Human Resource Policy BH-HR-705. Plus, save for higher education through the 529 College Savings Plan*
New! The MacDuffie School – Student Discount – The MacDuffie School, a preparatory school located in Granby, MA is offering
Baystate families an automatic 25% off tuition, with up to 90% tuition discount based on financial need. Daily bus transportation
between West Springfield and the Granby campus, with a stop in Holyoke is available with enrollment. This opportunity is available
to all employees and their children in grades 6-12. Learn more at macduffie.org/baystate-inquiry
Pregnancy, Birth & Adoption - Adoption assistance ($3,000 reimbursement per child, with yearly limit of two adopted children or
$6,000 adoption benefit), parenting classes, income replacement, job protection while on leave, and onsite lactation rooms & support
for nursing moms at work.
Pet Care - Save on your pet’s prescriptions and preventatives, plus get 24/7 vet Helpline access through PetPlus Discounts program.
Pet Insurance available through Nationwide at group discounted rates for your pet’s treatments, surgeries, lab fees, X-rays*.
Find out more about your Team Member Well-being benefits on the
web from work, home or on the go.
From home or mobile: baystatehealth.org/ employees/baystate-
healthy
From work: The Hub>Quick Links>Baystate Healthy
By email: BaystateHealthy@baystatehealth.org
* program/benefit fee
Enrolling in Baystate Health Benefits
When to Enroll in or Make Changes to Benefits
1. Open Enrollment: All employees can enroll in or make changes to Benefits every year during Benefits Open
Enrollment, which takes place in the Oct. – Nov. timeframe.
2. New Hire/Transfer: New employees and employees transferring to a new job within Baystate have 30 days from
their date of hire/transfer date to enroll in benefits.
3. Qualifying Life Event: Any employee who experiences a Qualifying Life Event (QLE) as defined by the IRS, is eligible
to enroll in or make changes to Benefits within 30 days of the QLE. Learn more about Qualifying Life Events.
How to Enroll in Benefits

Step 1: Visit Workday at www.baystatehealth.org/myWorkday and login using your Baystate Health network ID (EN +
5 or 6 digits) and password. If you access Workday from a computer or device outside of the Baystate network, DUO
authentication is required. DUO is a security application that protects your Workday account from being accessed by
anyone but you. If you are a new employee, you will first need to receive your initial (temporary) password from your
manager, before accessing any Baystate Health computer application.
Step 2: During Open Enrollment and for New Hire benefits enrollment, go to your Workday Inbox and select the
applicable benefit change task. If you are making a change because of a Qualifying Life Event, select the Benefits
application from your Workday home page, then select Benefits in the Change column.
Step 3: Answer the Spousal Affidavit question as applicable. Note: this question is being housed under the Tobacco
Use section in Workday.
Step 4: Review each available benefit. Choose Enroll or Manage to elect or make changes to each plan option.
Step 5: Review/update your elections for each plan using Select or Waive, and then Confirm and Continue.
Step 6: Select the Life Insurance tile to review, update or add a beneficiary to your life insurance coverage. To add a
beneficiary, select the + button. To learn how to update your beneficiary information anytime during the year, login to
Workday>Workday Support & Job Aids>Add or Change a Beneficiary.
Step 7: Review your plan enrollments and/or changes. If adding a dependent(s) and/or spouse for the first time,
attach the necessary documentation.
Step 8: When finished, click Review and Sign to review the summary and when ready, select “I Agree” and click then,
select Submit. Note: your changes will not be captured until you complete this step.
Step 9: Select the BenefitsPlus tile to review and/or make changes to your voluntary benefit elections.
When do Benefits Become Effective?
• For employees enrolling during Benefits Open Enrollment: All benefit plan elections will become effective on
January 1st of the following year.
• For new hires & job transfers: Medical, Dental, Vision, Life Insurance and Flexible Spending Accounts elections
become effective on the 1st of the month following your hire/transfer/QLE date. Short-term and Long-Term
Disability plans become effective the first of the month following 90 days of employment.
• For employees with a Qualifying Life Event: Effective date for QLE varies based on event.
• For additional detailed instructions on how to enroll in benefits, check out our Job Aids by visiting the Workday
homepage and selecting “Workday Support & Job Aids”.
• For more information about your Benefits, visit our employee intranet - The Hub >Quick Links>Benefits.
• For questions, contact HRAnswers at 413-794-4747.
Contact Us
For questions about your benefits, contact your recruiter or call HRAnswers at 413-794-4747.
After you start employment, visit Baystate Health’s employee intranet site where you will
find comprehensive information about your benefits: The Hub>Quick links>Benefits

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2024-2025

Professional Liability Insurance and Licensure

Health Insurance Benefits

Financial Building Benefits and Support

Income Protection Benefits

Team Member Well-being - Your Well-being and Worklife Benefits

Deductible $0 $1,000/$2,000 No Coverage

Preventive Care Exams No deductible, $0 copay No deductible, $0 copay No Coverage

Specialists No deductible, $40 copay No deductible, $50 copay No Coverage

Inpatient - Physician No deductible, then $0 copay Deductible, then $0 copay No Coverage

Outpatient – Physician No deductible, $0 copay Deductible, then 20% coinsurance No Coverage

Outpatient – Behavioral No deductible, $25 copay No deductible, $25 copay No Coverage

Lab & Radiology*

$10 Copay (up to 30-day supply

$30 Copay (up to 30-day supply

$50 Copay (up to 30-day supply

Deductible $0 $1,000/$2,000 $2,500/$5,000

Lab & Radiology*

Imaging* (CT Scans, MRIs, MRAs,

$10 copay (up to a 30-day supply)

$30 copay (up to a 30-day supply)

$50 copay (up to a 30-day supply)

In-Network Deductibles and OOP max’s cross-accumulate

Deductible, then 60% coinsurance

Deductible, then 60% coinsurance

Lab & Radiology*

How do copayments & coinsurance work?

Which tax-free savings accounts area available?

How does prescription coverage work?

How does it work when I receive care in different Network Tiers?

How many Tiers do our Plans have?

Tier 2: HNE / Extended Network* $$ • Moderate deductible

Tier 3: Out-of-Network $$$$ • Higher deductible

Support for your healthy lifestyle choices

This reimbursement* may be applied to:

See reverse for how to submit your reimbursement online.

Submit your reimbursement request online

Easy Access and Great Value – Your Delta Dental Networks

Simply visit www.deltadentalma.com to find a participating dentist in your area.

Baystate Health 2024 Rates Value Plan Choice Plan

Learn more at deltadentalma.com Your Plan is administered by:

Additional Benefit Information

Protective Restorations Once per tooth.

Major Restorative 50% 60% 50% 60%

Delta Dental of Massachusetts

of prescription eyeglasses FRAME

Your network is the place to start

Keep your eyes open for extra discounts

Remember, you’re never alone

Based on weighted average of sample transactions; EyeMed Insight

network/$10 exam copay/$10 materials copay/$120 frame or contact

Create a member account

For Baystate Health Employees

WHAT IS SHORT-TERM DISABILITY ForShort

ELIMINATION PERIOD Injury: None Sickness: 7 days

MAXIMUM WEEKLY BENEFIT 60% Plan: $3,500 per week

MAXIMUM BENEFIT DURATION Twenty (20) weeks

DEFINITION OF DISABILITY You are disabled when we determine that:

Resident Physicians and Pharmacy Residents

Investing involves risk, including risk of loss.