Staff Resources

Insurance Links

CT Partnership Health Plan

New HEP Requirements (2024)
Benefit Plan
Summary of Benefits and Coverage
State of CT Partnership Plan Details
Enrollment Form: Excel Spreadsheet or PDF File

Anthem State Bluecare POS - Medical

Customer Care: 1.866.611.8005
Find a Provider
LiveHealth Online Flyer
Special Offers Flyer
Websites:
- https://www.osc.ct.gov/ctpartner/index.html#medbene
- https://www.anthem.com/register/*

* Note: Create your own account online and view your benefits, claims, etc. at any time!

Cigna - Dental

Customer Care: 1.800.244.6224
Benefit Summary Flyer
Website: https://www.cigna.com/sites/stateofct-partnership/

State of CT Health Enhancement Program

CVS Caremark Prescription Benefit Program

Customer Care: 1.800.318.2572
Benefit Summary Flyer
Medication Coverage Exception Request Form
Mail Order Form
Website: http://www2.caremark.com/ctpartnership/

Qualifying Life Event for Insurance Enrollment

Have you waived insurance coverage and are now in need of coverage? Open enrollment is every June with a July 1 coverage start date unless you qualify for a special exception. If you qualify for a special exception, or need additional information regarding a special exception, please contact Human Resources or the Business Office.

Involuntary loss of other coverage.
- Cancelling the plan, voluntarily dropping coverage or failing to pay the premiums does not count as involuntary loss.
Becoming a dependent or gaining a dependent as a result of birth, adoption, or placement in foster care.
Turning 26 or older and aging off your parent's plan.
Marriage.
- If you get married, you have a 60 day open enrollment window that begins on your wedding day. Your policy will be effective the first of the month following your application, regardless of what date you complete your enrollment.
Divorce.
- If you lose your existing health insurance because of a divorce, you qualify for a special enrollment.
Becoming a U.S. citizen.

Additional Information Resources

Health Insurance Marketplace Coverage Options and Your Coverage

Not eligible for the Sprague Board of Education Health Insurance benefit or waiving coverage? The CT Marketplace is designed to help you find health insurance that meets your needs and fits your budget. The Marketplace offers "one-stop shopping" to find and compare private health insurance options. You may also be eligible for a new kind of tax credit that lowers your monthly premium right away.

The CT Marketplace Notice

Equitable Group Life Insurance

Life Insurance Enrollment Form

Connecticut Paid Leave

Contracts

Tuition Reimbursement

Forms / Templates *

Various school forms / templates have been made available for your use out of the building.

Tax Forms	CT-W4 Withholding Certificate
	W-4 Federal Withholding Certificate

FMLA - Family Medical Leave Act
Employee Information	Employee Guide to FMLA
Employee Forms	Employee's Serious Health Condition Form WH-380-E
	Exigency for Military Family Leave Form WH-384
	Family Members Serious Health Condition Form WH-380-F

Leave of Absence Request Form	To Fill Out (Word format)
< Instructions >	To Print Only

Mileage Requisition Form	To Fill Out (Excel format)
< Instructions >	To Print Only

Purchase Requisition Form	To Fill Out (Excel format)
< Instructions >	To Print Only

Field Trip Request Form	To Fill Out (Word format)
< Instructions >	To Print Only

Time Sheets	To Fill Out (Excel format)
< Instructions >	To Print Only

Extra Stipend Positions Form	To Fill Out (Word format)
	To Print Only

* If there is another form you would like to see made available on this page, please let me know so I can get it posted for you ~ Diane