DCRSD Employee Benefits
Information for the Dudley-Charlton Regional School District's benefits offering can be found in our DCRSD Benefits Enrollment Guide. All enrollment forms and additional information are listed below.
Click here to view the latest DCRSD Insurance Rates
Click here to download the DCRSD Election of Benefits Form
The DCRSD Election of Benefits form is required to be submitted to District along with the specific enrollment forms listed below.
Please contact Stacey Christiano, HR Director with any questions at 508-943-6888 ext. 148 or schristiano@dcrsd.org
2026-2027 Benefits Enrollment Guide
Important Enrollment Information
- Benefit Enrollment Periods
- Enrollment Forms
- Medical
- Dental & Vision
- Life Insurance
- Long Term Disability
- Flexible Spending Account
- Supplemental Retirement Savings Programs
- Family & Medical Leave Act
Benefit Enrollment Periods
Eligible employees and retirees have the opportunity to add, delete or change participation in the District’s medical and dental plans and/or change their status. There are three opportunities/periods of time where these changes can be made. See below for additional information and employee eligibility.
Enrollment Periods
New Employee to District
Benefit Eligibility Requirements
To be eligible for medical, dental, long term disability and life insurance benefits, you need to be scheduled to work at least 20 hours per week. If you are hired as a long term substitute position or other temporary position, you need to be employed for at least 91 days to be eligible for benefits on your first day of employment.
All benefit forms and required documentation to enroll must be completed and returned to Human Resources within 30 days of your start date.
Open Enrollment for All Staff
NEXT OPEN ENROLLMENT: May 2027
Each year eligible employees and retirees have the opportunity to add, delete or change participation in the District’s medical, dental and vision plans and/or change their status.
Please refer to the Insurance Rate Sheet effective 7/1/26 – 6/30/27 to determine the rate that coincides to your benefit plan choice for this current school year.
FLEXIBILE SPENDING ACCOUNTS: EMPLOYEES WHO WISH TO PARTICIPATE MUST ENROLL EVERY YEAR . The DCRSD Flexible Spending Plan ends June 30th of every year All funds from the previous year need to be used within the 75 day grace period at the end of the plan year. Any funds not used by that date will be forfeited.
A FSA is an IRS approved method which allows employees to use pre-tax dollars for medical (FSA) and dependent (DCA) care expenses. A new enrollment form indicating your yearly deduction amount is required for each new plan year. The elected deduction amount would be effective each year from July 1st to June 30th.
Visit the Flexible Spending Account tab for more information.
Life Status Change
Life Status Change Events
Participant changes in the district's benefit elections under the section 125 (medical, dental and vision) plans can normally only be made during open enrollment. However, there are some changes that can be made during the plan year within 30 days if it is determined that it is a qualifying event. There are five categories of events that can trigger a "change in status" during the plan year. These include:
- Employee's legal marital status changes, such as marriage, divorce, separation, or death of a spouse.
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A change in the number of dependents such as birth, death or adoption.
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Changes in employment status of the employee, or of the employee's spouse or dependents.
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A dependent becoming eligible or ceasing to be eligible for coverage due to age, student status, or obtaining other group coverage.
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A change in the residence of the participant, or the participant's spouse or dependent.
An election change must be due to one of the above listed reasons and the election change must be made within 30 days of the qualified event (documentation of the event and enrollment/disenrollment forms are required to initiate the change requested).
Enrollment Forms
Enrollment forms and additional information are listed below.
Questions? Contact Stacey Christiano, HR Director at 508-943-6888 ext. 148 or schristiano@dcrsd.org. You can also view the Benefit Enrollment Guide for more information.
DCRSD Election of Benefits Form
The DCRSD Election/Waiver form is a mandatory form that must be submitted to the Dudley-Charlton Regional School District's HR Department within 30 days of employment. If enrolling in Medical, Dental, Vision, Life Insurance or Disability Insurance, enrollment forms must be included with the DCRSD Election/Waiver From. Enrollment forms can be found below.
DCRSD Election of Benefits Form
DCRSD Insurance Rates - 2026-2027
DCRSD Benefit Enrollment Forms
If enrolling in Medical, Dental, Vision, Life Insurance or Disability Insurance, enrollment forms must be included with the DCRSD Election/Waiver From. Visit the individual benefits tabs to learn more information about each benefit plan.
Medical
Dental & Vision
Life Insurance
Long Term Disability
Flexible Spending Account Enrollment Form
If enrolling in the Dependent Care Assistance Program FSA (DCAP), the following form needs to be submitted to the Dudley-Charlton Regional School District's HR department within 30 days of employment. A new FSA enrollment election form must be made each year. Participation is voluntary.
Flexible Spending Account
Medical
Medical
This page provides staff with convenient access to information and resources related to the School District's medical benefits. Use the links and documents below to review benefit plans, access provider information, download forms, learn about enrollment and eligibility, and find answers to common questions. Whether you are enrolling for the first time, making changes during open enrollment, or seeking information about your current coverage, these resources are here to help you make informed decisions about your benefits.
Employee Support Resources
- Harvard Pilgrim Medical Enrollment Form
- Example of an Enrollment Form Filled Out
- Harvard Pilgrim New Provider Search
- Glossary of Health Coverage & Medical Terms
- MIAA Employee Assistance Program
Plan Information
- Harvard Pilgrim Access America Value 300-EPO
- Summary of Benefits
- Employee Benefit Handbook
- Schedule of Benefits
- RX Benefits 300 Plan Prescription Benefit Coverage
- Harvard Pilgrim Access America 300-PPO
- Summary of Benefits
- Employee Benefit Handbook
- Schedule of Benefits
- RX Benefits 300 Plan Prescription Benefit Coverage
- Harvard Pilgrim Access America Value 1000-EPO
- Summary of Benefits
- Employee Benefit Handbook
- Schedule of Benefits
- RX Benefits 1000 Plan Prescription Benefit Coverage
Dental & Vision
Dental & Vision
This page provides employees with easy access to information and resources related to the School District's dental and vision benefit plans. Use the links and documents below to review plan information, locate participating providers, access enrollment forms, and find answers to frequently asked questions. Whether you are enrolling in benefits, updating your coverage, or simply exploring your options, these resources are available to help you make informed decisions and maximize your dental and vision benefits.
Employee Support Resources
- Altus Dental and Vision Enrollment Form
- Example of an Enrollment Form Filled Out
- Altus Dental Preventative Rewards Program
Plan Information
- Altus Dental (high or low plan)
- Altus Vision 150
Life Insurance
Life Insurance
This page provides employees with access to information and resources related to the School District's life insurance benefits. Use the links and documents below to review coverage options, learn about eligibility, access beneficiary forms, and find answers to frequently asked questions. Whether you are enrolling in benefits, updating your beneficiary information, or seeking details about your current coverage, these resources are designed to help you understand and manage your life insurance benefits with confidence.
Employee Support Resources
- Life Insurance Enrollment Form
- Life Insurance Enrollment Form - Sample
- Life Insurance Change of Beneficiary Form Symetra
Plan Information
Long Term Disability
Long Term Disability
This page provides employees with access to information and resources related to the School District's long-term disability benefits. Use the links and documents below to learn about eligibility, coverage details and access the required forms. Whether you are enrolling in benefits, reviewing your coverage, or seeking information about filing a claim, these resources are available to help you understand and navigate your long-term disability benefits.
Employee Support Resources
Plan Information
Flexible Spending Account
FSA - A Flexible Spending Account
A Flexible Spending Account (FSA) allows you to set aside pre-tax dollars to pay for qualified medical and dependent care expenses, effectively lowering your taxable income and saving you money on taxes while covering costs like co-pays, prescriptions, dental visits, and childcare, which you would otherwise pay with after-tax dollars; essentially giving you access to a portion of your salary before taxes are taken out to use on eligible expenses throughout the year.
Supplemental Retirement Savings Programs
Supplemental Employee Retirement Savings Program
This page provides employees with information and resources to help you plan and save for retirement through the School District's voluntary retirement savings programs, including the 403(b) Plan and the 457 Smart Plan. Use the links and documents below to learn about plan features, eligibility, enrollment, investment providers, contribution limits, and other retirement planning resources. Whether you are enrolling for the first time, increasing your contributions, or reviewing your retirement savings options, these resources are available to help you make informed decisions and prepare for your financial future.
Employee Support Resources
The SMART Plan is a retirement savings program authorized under section 457 of the Internal Revenue Code, commonly called a 457 deferred compensation program, that allows eligible employees to save and invest before-tax and after-tax dollars through salary deferrals (contributions)
The 403(b) program is designed to offer a broad range of quality mutual funds and annuities that provide an opportunity to build a diversified retirement plan portfolio.
Click here to view or download the 403(b) Plan Overview
Family & Medical Leave Act
Family and Medical Leave Act
This page provides employees with information and resources related to leave available under the Family and Medical Leave Act (FMLA). Use the links and documents below to learn about eligibility requirements, qualifying reasons for leave, employee rights and responsibilities, required forms, certification requirements, and frequently asked questions. Whether you are requesting leave for your own serious health condition, to care for a qualifying family member, or for another FMLA-qualifying reason, these resources are available to help you understand the process and access the information you need.