Health Insurance Opt-out Program Application
Thanks for your interest in the health insurance opt-out program. This program is being offered in an effort to reduce the cost of the Town’s Health Insurance premium costs. The incentive will be offered to enrollees that have received health insurance benefits through the Town for the immediate prior 12 months.
You will need to upload the following documents as part of the application. Please have them completed and ready to submit.
- Health Insurance Responsibility Disclosure Form (HIRD)
- Written documentation of alternative health insurance covered outside of the Town’s group plans on employer letterhead
If you have any questions or trouble filling out the application, please contact Joan Chase, Human Resources Analyst at
chasej@grafton-ma.gov or 508-839-5335 x1129.