Benefits Open Enrollment

Benefits Enrollment Forms

Hello everyone, its open enrollment time again.  Below find the links to the forms you need to enroll in the districts benefits programs.  This year the items are separated into sections on the website by bargaining unit.  Note that forms are due back to the Benefits Office by no later than June 1 2022.  Open enrollment for the 2022-23 school year is effective on July 1 2022.

 

BEA 2022-23 Enrollment Forms and Info

During contract negotiations with the Board of Education, the BEA elected to join the State of CT's State Partnership Plan health Insurance.  You will need to fill out some of the enrollment forms listed below.  If you have not already done so, please read the letter to BEA members about the changes.


Click the following link to read a letter describing the new benefits agreed to by the BEA.

Letter to BEA members on Open Enrollment

Enrollment Forms

Enrollment and BOE Compensation Reduction Form
SPP Health Enrollment Form

Cost Information:

BEA Rates

Other Forms you may need:

WageWorks Flexible Spending Account Enrollment Form 

Aetna Beneficiary Form

Sick Bank Enrollment Form 

Aetna Enrollment Form

Other Documentation you may need:

AFLAC Summary

SPP Medical Plan Summary

SPP Dental Plan Summary

SPP Vision Plan Summary
How to Start a 403(b) deduction

Humana Employee Assistance Program



All Other Bargaining and Non Bargaining Unit Employees
2022-23 Enrollment Forms and Info


Click link below to read the Enrollment letter to All Staff Non BEA
Open Enrollment Letter to Staff non - BEA.docx

Enrollment Forms

Enrollment and BOE Compensation Reduction Form - non BEA
CIGNA Enrollment Form (Both PPO and High Deductible)

Cost Information:

BAA Rates
BFEP Rates
BSNA Rates
NB 2022-23 Rates
UPSEU Rates

Other Forms you may need:

WageWorks Flexible Spending Account Enrollment Form 
Aetna Beneficiary Form
Sick Bank Enrollment Form
Aetna Enrollment Form

Other Documentation you may need:

AFLAC Summary
CIGNA Open Access PPO Plan SPD.pdf
CIGNA High Deductible Health Plan SPD.pdf
CIGNA Dental Plan Summary
CIGNA Vision Plan Summary
How to Start a 403(b) deduction
How to open HSA account at Liberty Bank
Humana Employee Assistance Program
Cigna PPO $15 Copay - UPSEU Only

If you have any questions please contact: Terry Davenport District Benefits Coordinator



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