NH Service Staff Benefits
Information and Forms
- New Costs (Effective 7/1/2025): Annual Employee Contribution
- New Costs (Effective 7/1/2025): Monthly Premiums (to be used for part-time or mid-year calculations)
- Old Costs (Effective 7/1/2024): Annual Employee Contribution
- Old Costs (Effective 7/1/2024): Monthly Premiums (to be used for part-time or mid-year calculations)
- Health Savings Accounts (HSA) & Health Reimbursement Accounts (HRA)
- Dental Insurance
- VSP Vision Insurance
- Forms
- 403(b) Information
- Benefit Information
- Required Notices
New Costs (Effective 7/1/2025): Annual Employee Contribution
Annual Employee Medical Contribution
Costs will be prorated for employees working less than full time or enrolled in coverage for less than a full year.
Harvard Pilgrim HMO Silver Plan
Employer pays 95% of monthly premium, employee pays 5% of monthly premium.
To calculate bi-weekly deductions, divide the annual employee cost listed below by the number of paychecks you receive July - June. If you are unsure how many paychecks you receive, contact a Human Resources team member.
Contribution Rates Based on 1.0 FTE (40.00 hours per week), 12 months of coverage - July-June.
Individual
Monthly district portion: $843
Annual district portion: $10,119
Monthly employee cost: $45
Annual employee cost: $532
Employee + Child
Monthly district portion: $1,685
Annual district portion: $20,212
Monthly employee cost: $89
Annual employee cost: $1,064
Employee + Spouse
Monthly district portion: $1,937
Annual district portion: $23,245
Monthly employee cost: $102
Annual employee cost: $1,224
2 + enrollees
Monthly district portion: $2,560
Annual district portion: $30,723
Monthly employee cost: $135
Annual employee cost: $1,617
Annual Employee Dental Contribution
Costs will be prorated for employees working less than full time or enrolled in coverage for less than a full year.
The district pays the cost of single dental coverage for Full-Time employees, employee bears all of the difference if they wish to carry 2 Person or Family coverage.
Single: $0
2 Person: $606.24
Family: $1,597.44
Annual Employee Vision Contribution
Vision benefits are voluntary and the employee pays 100% of the premium.
Single: $37.92
2 Person: $75.84
Family: $122.16
New Costs (Effective 7/1/2025): Monthly Premiums (to be used for part-time or mid-year calculations)
Monthly Medical Premiums (billed to District)
Costs will be prorated for employees working less than full time or enrolled in coverage for less than a full year. If you need assistance calculating your prorated medical or dental costs contact a Human Resources team member.
Individual
$887
Employee + Child
$1,773
Employee + Spouse
$2,039
2 + enrollees
$2,695
Monthly Dental Premiums (billed to District)
The district pays the cost of single dental coverage for Full-Time employees, employee bears all of the difference if they wish to carry 2 Person or Family coverage.
Single: $54.21
2 Person: $104.73
Family: $187.33
Monthly Vision Premiums (billed to District)
Vision benefits are voluntary and the employee pays 100% of the premium.
Single: $3.16
2 Person: $6.32
Family: $10.18
Old Costs (Effective 7/1/2024): Annual Employee Contribution
Annual Employee Medical Contribution
Costs will be prorated for employees working less than full time or enrolled in coverage for less than a full year.
To calculate bi-weekly deductions, divide the annual rates listed below by the number of paychecks you receive July - June. If you are unsure how many paychecks you receive, contact a Human Resources team member.
Contribution Rates (5% for HMO Super, 10% for EHO and 15% for HMO LP), *Based on 1.0 FTE (40.00 hours per week), 12 months of coverage - July-June.
HMO Super
Single: $651.88
2 Person: $1,304.10
Family: $1,761.75
EHO
Single: $1,410.68
2 Person: $2,802.05
Family: $3,785.38
HMO LP
Single: $2,281.61
2 Person: $4,568.02
Family: $6,171.07
Annual Employee Dental Contribution
Costs will be prorated for employees working less than full time or enrolled in coverage for less than a full year.
The district pays the cost of single dental coverage for Full-Time employees, employee bears all of the difference if they wish to carry 2 Person or Family coverage.
Single: $0
2 Person: $577.32
Family: $1,521.36
Annual Employee Vision Contribution
Vision benefits are voluntary and the employee pays 100% of the premium.
Single: $37.92
2 Person: $75.84
Family: $122.16
Old Costs (Effective 7/1/2024): Monthly Premiums (to be used for part-time or mid-year calculations)
Monthly Medical Premiums (billed to District)
Costs will be prorated for employees working less than full time or enrolled in coverage for less than a full year. If you need assistance calculating your prorated medical or dental costs contact a Human Resources team member.
HMO Super
Single: $1,086.47
2 Person: $2,173.50
Family: $2,936.25
EHO
Single: $1,167.23
2 Person: $2,335.04
Family: $3,154.48
HMO LP
Single: $1,268.56
2 Person: $2,537.79
Family: $3,428.37
Monthly Dental Premiums (billed to District)
The district pays the cost of single dental coverage for Full-Time employees, employee bears all of the difference if they wish to carry 2 Person or Family coverage.
Single: $51.63
2 Person: $99.74
Family: $178.41
Monthly Vision Premiums (billed to District)
Vision benefits are voluntary and the employee pays 100% of the premium.
Single: $3.16
2 Person: $6.32
Family: $10.18
Health Savings Accounts (HSA) & Health Reimbursement Accounts (HRA)
-
Health Savings Accounts (HSAs): These are personal accounts where you and/or your employer can contribute pre-tax dollars to pay for qualified medical expenses. You can also use HSAs to save for retirement.
-
Health Reimbursement Arrangements (HRAs): These are employer-sponsored accounts where the employer deposits funds into the account, which you can then use to pay for eligible medical expenses. HRA funds are owned and controlled by the employer.
-
Visit the Employee Navigator portal to complete your enrollment.
-
Visit the csONE portal to view HSA and HRA balances, manage claims, and submit for reimbursements.
Dental Insurance
VSP Vision Insurance
Highlights:
- Voluntary, employee-paid insurance
- VSP Choice Network, plus Walmart, Visionworks, & Pearle Vision
- No ID card required
- Extra discounts & savings included
- Lenses: $25 copay
- Frames (every other plan year): $150 allowance , $200 for featured brands
- Contact lenses (in lieu of glasses): $150 allowance
Forms
403(b) Information
403(b) Vendor List & Enrollment Instructions
403(b) Contributions & District Match
Employees may reduce or stop their 403(b) contributions at any time during the year.
To begin or make a change to your 403(b) contributions, follow these steps:
Step 1: Visit https://omni403b.com/SRA
Step 2: Under "Select Employer State", choose "NH".
Step 3: In the "Employer Name" box, enter the following:
- Marion Cross employees: "Town of Norwich School District"
- Ray employees: "Hanover School District"
- Richmond Middle employees: "Dresden School District"
- Hanover High employees: "Dresden School District"
Step 4: Follow the prompts to enter and submit information about your 403(b) contribution.
Prior to contributing, you must open an account with an investment provider participating in the Plan (see list on page 2 of the 403b Overview). Once you have opened an account, follow the steps below to create a Salary Reduction Agreement.
Salary Reduction Overview Video
Benefit Information
Required Notices
In This Section
Frequently Asked Questions
- When can I enroll for health and/or dental benefits?
- How do I add someone to my health insurance?
- What is a qualifying event?
- What is a Flexible Spending Account (FSA)?
- What retirement options are available to me?
- What percentage matching is available for retirement?
- When and how can I change my retirement contributions?
- How do I change my address or phone number?
- Medical Cost-Sharing
When can I enroll for health and/or dental benefits?
Open enrollment is held annually in May. During the open enrollment period you may elect to:
- Enroll in the plan(s) that you are eligible for
- Drop current coverage
- Add/Remove dependents from the plan(s)
Changes made during open enrollment will be effective on July 1st.
In addition to the open enrollment period, you may be eligible to make changes to your existing elections if you or a family member experiences a qualifying event.
How do I add someone to my health insurance?
What is a qualifying event?
Qualifying Events
Loss of other health coverage
- Losing existing health coverage, including job-based, individual, and student plans
- Losing eligibility for Medicare, Medicaid or other government programs
- Turning 26 and losing coverage through a parent's plan
Household changes
- Getting married or divorced
- Having a baby, adopting a child or gaining guardianship of a child
- Death in the family
Changes in residence
- Moving outside the coverage area
What is a Flexible Spending Account (FSA)?
What retirement options are available to me?
What percentage matching is available for retirement?
When and how can I change my retirement contributions?
Employees may reduce or stop their 403(b) contributions at any time during the year.
To begin or make a change to your 403(b) contributions, follow these steps:
Step 1: Visit https://omni403b.com/SRA
Step 2: Under "Select Employer State", choose "NH".
Step 3: In the "Employer Name" box, enter the following:
- Marion Cross employees: "Town of Norwich School District"
- Ray employees: "Hanover School District"
- Richmond Middle employees: "Dresden School District"
- Hanover High employees: "Dresden School District"
Step 4: Follow the prompts to enter and submit information about your 403(b) contribution.
Prior to contributing, you must open an account with an investment provider participating in the Plan (see list on page 2 of the 403b Overview). Once you have opened an account, follow the steps below to create a Salary Reduction Agreement.
For additional information, please review the 403(b) Guidelines.
How do I change my address or phone number?
If you have had a change of address, phone number, email, or name, please complete the Address Change Form. Submit an original of this form to the Human Resources office to update payroll systems, insurance vendors, etc. with your new information.