• City Pension Beneficiary Form
• Disability Pension Application
• Service-Based/Vested Pension Application
• Contribution Withdrawal Application
• Direct Deposit Form
• Employee Personal Data Change Form
• Federal Withholding Certificate for Pension and Annuity Payments
• State (CT) Withholding Certificate for Pension and Annuity Payments
• Link to State Teacher’s Retirement Website
• Link to Social Security
• Link to Medicare

Medical & Dental: 

• Anthem Enrollment/Change Form
• Anthem Medical Claim and Prescription Reimbursement Form
• Dental Claim Form
• Link to Anthem Web site

Plan Descriptions:

• Century Preferred Plan Description
• Point of Service Plan Description
• Point of Enrollment Plan Description
• Century Preferred Plan Description - Fire
• Point of Service Plan Description - Fire
• Point of Enrollment Plan Description - Fire
• Plan Comparison Spreadsheet
• Plan Comparison Spreadsheet - Fire
• Full Dental w/Rider A Plan Description - Fire
• Flex Dental 2 Plan Description

Pharmacy:

• Medco Plan Summary
• Medco Plan Summary - Fire
• Medco Claim Form
• Medco COB Form
• Medco Mail Order
• Medco Business News

Rates:

• 2010 - 2011 Teachers & SAW
  • Teachers & SAW Rate Distribution
• 2010 – 2011 - Fire
• 2010 – 2011 - All others (12 month EE’s)
• 2010 – 2011 - All others (10 month EE’s)

Flexible Spending Account:

• Enrollment Form
• Claim Form
• FSA Participant Status Change Form
• Express Card Information
• Express Card Information Update, January 2009
• Express Card Frequent Decline Reasons, January 2009
• Flex – Direct Deposit Authorization Form
• Over The Counter List

Life Insurance:

• Notice of Carrier Change 
• AnthemLife – Resource Advisor 
• Special Offers @ Anthem 
• Travel Assistance Information 
• Beneficiary Designation Form 

Certificates of Coverage:

• Blue Collar 
• White Collar 
• Management 
• Police 
• Fire 
• WTA 
• SAW 
• Nurses 
• SEIU 
• Elected & Appointed Officials 

Employee Assistance Program:

• Link to ESI website
• Link to ESI video

Frequently Asked Questions:

• Health, Dental and Pharmacy FAQ’s
• Life Insurance FAQ's
• Health FAQ’s Teacher Retirement Board
• HIPAA Notice – Your Right To Privacy