Benefits information and plan summaries are available online at www.stamfordpublicschools.org. Hover over Staff, click Benefits, and then Benefit Plan Information.
All insurance changes need a qualified event and this form and all necessary documentation must be submitted within 30 days of the qualified event. If your benefits forms are not submitted to the Benefits Administration Office within 30 days of your qualified event, you will not be permitted to enroll until the next Open Enrollment in November or if you experience another qualified life event change.
Spouse and dependent information must match employee coverage.
Dependent children may be covered until the end of the year that they turn 26.
All forms and documentation must be approved by the benefits office before any changes can be processed.
WHEN COVERAGE BEGINS & OPEN ENROLLMENT
Coverage will begin the first of the month following when this form and appropriate documentation is submitted, premium contributions may have to be adjusted.
Coverage for newborns will begin on the date of birth, premium contributions may have to be adjusted.
If you are unsure if you have a qualified event please contact the Benefits Office at (203)977-4196 or (203) 977-4975.
Please ensure you provide documentation via upload below or sent within 30 days of the qualified event to the BOE HR Department via email to BOEBenefits@StamfordCT.gov or fax to (203) 977-4043.