Insurance & Benefits


Lucy Gennuso
Insurance & Benefits Coordinator

Middletown Public Schools
311 Hunting Hill Avenue
Middletown, CT 06457

Phone: 860-638-1409
Fax: 860-638-1457

Connecticut Partnership Plan 2.0 - Teachers & Paraprofessionals (Effective 10/1/2017):

State of Connecticut Partnership Plan - Important Changes - October 1, 2017

State of Connecticut Partnership Plan changes effective March 1, 2018 Site of Service

State of Connecticut Partnership 2.0 brochure - 2018

State of Connecticut SEBAC Change Partnership Plan Brochure

UnitedHealthcare (Medical): - Contains information regarding the Partnership Plan, HEP information, how to search for a provider and more

State of Connecticut HealthAllies Discount Program

State of Connecticut Partnership Plan 2.0 Enrollment Form & Waiver

State of Connecticut Partnership Plan - Add/Terminate/Change Form

Health Enhancement Program (HEP):

State of Connecticut Health Enhancement Program Requirements (HEP) 2018

State of Connecticut HEP Program - Care Management Solutions

HEP Physician Notification Form (PNF)

State of Connecticut Emergency Room Waiver Form

CVS Caremark (Pharmacy):

Aetna Life Insurance Form:

AETNA Life Insurance Beneficiary Form

Aetna - The Health Section

Each week, check out The Health Section, Aetna's external website that publishes timely news and analysis about innovation, issues and ideas that are shaping health care today and tomorrow.

Like what you see? You can add The Health Section to your mobile device for easy reading any time. And follow us on Twitter at our new handle, @AetnaNews.

Aetna Medical Benefit Summaries & Enrollment and Change Form

Aetna Summary of Benefits and Coverage Medical Plan – Administrators 

Aetna Summary of Benefits and Coverage Medical Plan – Administrators High Deductible Health Plan (HDHP)

Aetna Enrollment and Change Form

Aetna Medical Detailed Benefit Plan Booklet & Appeals Process

Aetna Benefit Detailed Booklet – Administrators Plan

Aetna Plan Detail Booklet for Administrators HDHP

Aetna Complaint and Appeals Process

Aetna Navigator - online registration to view claims and statements

Doc Find - to find doctors in network

Aetna Health and Wellness Programs:

Disease Management Program

Registered Nurse Support

Informed Health Line - 24 hours

Beginning Right Maternity Program

Aetna Personal Health Record

Cigna Dental

State of Connecticut Cigna Dental Care DHMO Patient Charge Schedule eff 9/1/2016
(Teachers and Paraprofessionals Only)

State of Connecticut Cigna Dental Care Enrollment Form -Teachers and Paraprofessionals Only

Cigna Dental (PPO) Summary of Benefits - Teachers and Paraprofessionals Only

Cigna Dental (PPO) Summary of Benefits for Administrators

Cigna Dental Directory (find a dentist)

Cigna Dental Wellness:

Cigna Dental Cost Estimator

Cigna Healthy Smile, Healthy Baby

Cigna Healthy Smiles Start at Home

Cigna Protect your Mouth, Protect your Health


Reminder regarding the Age Limit for Dependents:

  • 26 years for dental (coverage ends at the end of the birth month in which the dependent turns 26 years old.) Ex. Dependent turns 26 years on 7/2/16, coverage ends on 7/31/16.
  • 26 years for medical, including prescription drug(coverage ends at the end of the birth month in which the dependent turns 26 years old). Please contact the Insurance & Benefits Office at to notify them when your dependent is approaching this age. He/she would be eligible for Cobra continuation.

Life Insurance – Beneficiary Designation

Life insurance is administered by The Aetna. Coverage is at no cost to you. It is important to always make certain you have designated the person(s) or legal entity that you desire to receive payment of your life insurance benefit in the event of your death. This information is maintained in the Insurance & Benefits Office. You can find a Beneficiary Designation Form on the BOE website under Human Resources and then click on Insurance and Benefits.

Births, Marriages, Divorces

A copy of the birth certificate, marriage certificate or divorce decree page showing date of divorce, will be required upon changes to status. Social Security Numbers are now required to enroll dependents for purpose of reporting coverage status to the IRS. You have 30 days to notify this office  but sooner would be appreciated. If you don't notify this office in writing within 30 days of birth or marriage, then your dependent cannot be enrolled until the next open enrollment generally held every June for an effective date of July 1st. If you lose coverage through your spouse's employer and wish to enroll in the BOE plan, you must submit a letter from the employer on company letterhead indicating the names of all dependents being terminated, the date of termination and the reason. (typically, it is due to layoff) You cannot cancel other coverage simply because you prefer this plan, unless it is during open enrollment period.

Student/Sports Accident Insurance:

Bollinger Student Voluntary Insurance Claim Form and Instructions 2018-2019

Bollinger Student/Athletic Insurance Claim Form and Instructions 2018-2019

Student Accident & Injury Report

Student ATHLETE Accident & Injury Report for Coaches and Trainers 

Worker's Compensation (CIRMA) Information (Click on this link for more information and forms)

Statement of Board of Education Executive Management Commitment to Risk Management dated November 27, 2012

Revised Notice of Privacy (Click on this link)

Affordable Care Act Information

Federal Health Insurance Marketplace or "Exchange" Notice

Other Plan Information and Notices

Aetna Disclosure Information (pdf format)

Aetna Privacy Statement (pdf format)

General Notice of COBRA Continuation Coverage Rights (Revised October, 2014)

Creditable Coverage Notice (October, 2015)