Retired Employees

Blue Cross Blue Shield

• Member Services Phone: 800-782-3675
• Blue Cross Blue Shield Website

Plan Summaries:

• HMO Deductible Plan (PDF)
• PPO Deductible Plan (PDF)
• HMO High Deductible Plan (PDF)
• PPO High Deductible Plan (PDF)
• Vision Rider (PDF)
• Dental Plan (PDF)
• Medex 2 Plan (PDF)
• Blue Medicare Rx Plan (PDP) (PDF)

Forms:

• Enrollment Form (PDF)
• Medex Subscriber Form (PDF)
• Subscriber Claim Form (PDF)
• Student Affidavit Form (PDF) (Dependent Dental coverage for full-time students age 19 to 23)
• Fitness Reimbursement (PPO and HMO plans) (PDF)
• Weight Loss Reimbursement (PPO and HMO plans) (PDF)

Rates:

• Insurance Rates Effective July 1, 2021 (PDF)

Boston Mutual

• Beneficiary Change Form (PDF)

Retirement Boards

Middlesex County Retirement System

25 Linnell Circle
P.O. Box 160
Billerica, MA 01865
Phone: 978-439-3000 or 800-258-3805
Middlesex County Retirement System Website

Hours
Monday through Friday
8:30 am to 5 pm

Forms:

• Address Change (PDF)
• Name Change (PDF)
• Beneficiary Change (PDF)

Massachusetts Teachers Retirement System (MTRS)

500 Rutherford Avenue
Suite 210
Charlestown, MA 02129-1628
Phone: 617-679-6877 (MTRS)
MTRS Website