Below are the forms you will need to enroll in or decline Health and Life Insurance, and Flexible Spending Accounts (FSAs).
Spouses & Dependents
Please note: To enroll a spouse you must include a copy of your city or town issued marriage certificate or your divorce decree and a copy of their Social Security Card. To enroll dependent children under age 26 you will need to include birth certificates, adoption forms or guardianship papers a copy of their Social Security Card.
All applications and accompanying paperwork must be received by Wendy Ricciardi, Benefits Administrator, in the Treasurer's Office within 30 days of your hire date.
If you do not enroll during your initial enrollment window your next opportunity will be during the annual Open Enrollment with the coverage effective date of July 1st, unless you experience a qualifying event.