Open Enrollment


, CT  06470




DATE:         May 11, 2018
TO:              Eligible Employee
FROM:        Denise Hornyak, Insurance Coordinator
SUBJECT:  Medical/Dental Insurance – Open Enrollment
                    Response Required by June 8

Open enrollment will occur between May 11th and June 8th this year for medical, dental, and voluntary vision insurance coverage that will begin on July 1.  You will have the opportunity to enroll for the first time, make a change to your current election, add or cancel dependents, or waive the insurance during this period only.  The next open enrollment period will not occur until May/June 2019 for plan coverage during 2019-20.  Changes outside the open enrollment period are only permitted if a qualified change in life status has occurred.

As of July 1, 2018, all Non-Affiliated (Individually Contracted) employees currently enrolled in the Anthem PPO 30/40 coverage will be automatically enrolled in the HSA. 

  • If you do not want to be automatically transferred or do not want to re-enroll in the HSA plan, you must complete an Insurance Waiver Form waiving medical coverage for the 2018-2019 plan year.
  • Employees or their spouses that are currently contributing to a Flex Medical Account and/or an employee who has Medicare are not eligible to enroll in an HSA.  Please refer to additional information provided on the website regarding IRS regulations for HSA, Medicare, Flex Medical Accounts, and other insurance coverage with a spouse.      
  • If you choose to enroll in the HSA for the first time, you must complete an Insurance Election Form, and if desired a HSA Payroll Deduction Form.

if you are enrolling for the first time or adding a dependent, along with your Insurance Election Form, you must complete an Anthem Enrollment Form for health insurance, a TR Paul Enrollment Form for dental insurance, and an Anthem Voluntary Vision Enrollment Form.  In addition, the following information must be submitted along with the membership application:

RELATIONSHIP                                                                   DOCUMENT REQUIRED

Spouse                                                                                Marriage Certificate
Party To A Civil Union                                                          Civil Union Certificate

Dependent Child (Under Age 21)

            Birth Parent                                                              Birth Certificate

           Legal Guardian                                                         Legal Guardian Documentation

            Adoptive Parent                                                       Adoption Decree or Birth Certificat
           Step Parent                                                              Tax Forms Indicating Child is Claimed As A
Dependent Child (Over Age 21)                                          Proof of Full-Time Student Status (Dental Only)
Disabled Child (Over Age 26)                                             Completed Medical Verification Form

All forms MUST be returned by June 8th if you wish to make a change during open enrollment.  If the form(s) are not received by the deadline, you will automatically be enrolled in the same plan coverage you elected this year with the exception of Non-Unaffiliated (Individually Contracted) employees.  If you do not wish to make a change to your coverage, you are not required to return an enrollment form. 

Payroll deductions will be taken in 20 equal payments between 8/31/18 and 5/24/19.  If you are not scheduled to be paid on 8/31, two payments will be taken the following payroll.  ParaEducator payroll deductions will be taken out in 19 equal payments between 9/14/18 and 6/07/19.   The required employee contribution is detailed on the appropriate employee Insurance Election Form.

Information for all eligible employees and necessary forms to enroll in the medical, vision and/or dental insurance coverage can be obtained as of Friday, May 11th, on the Newtown District Website,, and can be accessed by clicking on the Department/Business Office, Employee Insurance Information and Forms 2018-2019 and referring to the appropriate box for information and forms. 

Please send completed forms directly to me.  Should you have any questions, please email me at or call (203) 270-4569.

The IRS Health Saving Account (HSA) limits for 2018 (in PDF)