Benefits Forms
GIC enrollment forms can be completed and submitted electronically through a secure email link. This electronic capability, myGIC Link, streamlines the benefit enrollment and change process. Contact the Employee Benefits Dept. at (413) 787-6055 or email: benefits@springfieldcityhall.com and the link will be requested for you from the GIC.
Please review the list of additional required documents if you have dependents or are turning 65!
Boston Mutual Life Insurance
The City of Springfield will be moving to Boston Mutual Life Insurance effective July 1st, 2024.
Boston mutual will be accepting all current plans that you have with Guardian. The cost for the $5,000 will be $3.50 per month. You will be able to keep all of your currentl Supplement Life Insurance policies with Boston Mutual.
If you do not currently have Life Insurance, you may enroll in this program during Open Enrollment but you may need to complete an Evidence of Insurability Form and possibly submit to a physical in order to participate.
If you want to cancel your Life Insurance or make changes you may complete a Life Insurance Change Form. If you haven’t updated your beneficiary information in a while, please fill out the Beneficiary Form to update your information.
Flex Spending Accounts (FSA)
AmeriFlex by Colonial Life FY25 FSA Enrollment Form
You must enroll/re-enroll each year you would like to participate in Flexible Spending.
Email FSA Forms to benefits@springfieldcityhall.com or call AmeriFlex at 888-868-3539 to enroll. Please be advised that you must be eligible for health insurance to enroll in FSA/DCFSA, but you do not need to enroll in health insurance to sign up for FSA/DCFSA.
Chat: www.myameriflex.com Phone: 888-868-3539 or Email: service@myameriflex.com
Cigna Dental & Vision
Cigna Enrollment/Buy Up Form - Enrollment in plans can be completed by completing the Cigna enrollment form and returning it to the Employee Benefits Department.
Deferred Compensation Program
If you wish to join the SMART Plan and begin your contributions, you must complete a new enrollment form. Completed forms can be mailed or delivered to the City of Springfield, Attention: Benefits Department, 36 Court Street, Room 18, Springfield, MA 01103. Please ensure that all information requested on the form is complete. We will not be able to process forms until all of the information is correct. Please note that SMART Plan enrollment can be completed at any time during the year.
If you would like to obtain more detailed information regarding the SMART Plan, please visit their website at www.mass-smart.com or call 877.457.1900
For quick and convenient service, contact your local representative:
Dan Moroney, CFP at 413-335-0542 or Dan.Moroney@Empower-Retirement.com
Downtown Parking for Employees
Please fill out the forms below to set up your parking deduction
Monthly Parking Deduction Form - This form authorizes the City to deduct payment for your parking from your paycheck*
Forms may be emailed to benefits@springfieldcityhall.com or sent to Benefits Room 018
*Please Note: Authorization for payroll deduction must be given prior to the first day of the month that parking will begin in order for the City to begin payment.