Dental School Contacts

• Employment Questions

John Brigada
Director of Finance & Administration
Office: 860-679-4065
E-mail: jbrigada@uchc.edu

• Program Questions

Jaqueline Duncan, DMD, MDSc
Interim Associate Dean for Clinical Affairs
Office: 860-679-3745
E-mail:  jduncan@uchc.edu

Overview

Tax Forms

• W-4 Instructions
• W-4 Form
• CT W-4 Instructions
• CT-W4 Form

Medical and Dental

• Medical Overview.pdf
• Pharmacy Overview.pdf
• Specialty Pharmacy/Drugs.pdf
• Home Delivery Order Form.pdf
• Dental Overview.pdf
• Medical/Dental Benefit Booklet and Summary of Benefits and Coverage.pdf
• 2019 Benefits Notices Booklet.pdf
• Enrollment Application.pdf
• Medical/Dental Waiver Form.pdf
• Find an In Network Provider.pdf
• Out of Network Claim Form.pdf

Plan Documents

• Wrap Summary Plan Description.pdf
• Anthem Certificate of Coverage.pdf
• Section 125 Premium Conversion Plan.pdf

Vision

• Overview
• Application
• Blue View Waiver Form

Life Insurance

• Life Insurance Change of Beneficiary Form
• Anthem Certificate

Insurance Benefits While Traveling

• Anthem International Travel.pdf
• Blue Card Claim Form.pdf
• Travel Assistance.pdf

Disability Insurance

• Disability Insurance.pdf
• Disability Conversion Information.pdf
• Disability Agent Contact Information.pdf

Work Related Injury - Workers' Compensation

• Work Related Injury - Workers' Compensation.pdf
• Purple Card Procedures
• Safety Committee Rosters

Malpractice

Banking Information

• Berkshire Bank
  • Exclusive Offer For New Residents
  • The Doctor’s Advantage Home Loan
• Citizens Bank
  • Student Loan Refinance & New Loans
  • Doctors Mortgage Program
• People's United Bank
• Webster Bank
  • Exclusive Offer For New Residents

Financial Information

• Direct Deposit Authorization Form
• Instructions to View your Direct Deposit Paystub/W-2 Online
• Investment Resources
• Tax Sheltered Investment Program (403b)
  • Salary Deferral Agreement 403(b)

• Dependent Care Reimbursement Account (Pre-tax Childcare Expense)

• Dependent Care Enrollment Form.pdf

Student Loan Debt Information

• AAMC Debt Management Resource
• Public Service Loan Forgiveness Form
• Debt Consolidation Information - Citizens Bank

Counseling Programs

• Anthem Resource Advisor.pdf
• Anthem Psychology Online – licensed therapy at home.pdf
• Guardian Employee Assistance Program.pdf

Discounts

• Go Here to view Discounts available to employees

Exiting Residents

• Exiting Instructions
• Sign Out Sheet
• Payroll Forwarding Address

COBRA

• COBRA Election Notice
• COBRA Coverage Rights

COBRA ALTERNATIVES

• Health Insurance Exchanges

DISABILITY/LIFE AGENTS

• The Guardian/Berkshire Life

PHYSICIAN MORTGAGE PROGRAMS

• Berkshire Bank Home Loan
• Citizens Bank Doctor's Mortgage Program