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Employee Benefits
Employee Benefits (Forms and Information)
- 2023 to 2024 UnitedHealthCare Enrollment Change Form (PDF)
- Town of Darien Health Plan Notice Packet FY2024
- United Healthcare 2023 to 2024 Summary of Benefits and Coverage Q&A - $2,500 to $5,000 Deductible (PDF)
- UnitedHealthcare 2023 to 2024 Summary of Benefits and Coverage Q&A - $2,000 to $4,000 Deductible (PDF)
- UnitedHealthcare Choice Plus Benefit Summary - $2,000 to $4,000 Deductible (PDF)
- UnitedHealthcare Choice Plus Benefit Summary - $2,500 to $5,000 Deductible (PDF)
- UnitedHealthcare Choice Plus Welcome Brochure (PDF)
- UnitedHealthcare Quit for Life (PDF)
- UnitedHealthcare Real Appeal Weight Management Brochure (PDF)
- UnitedHealthcare Rewards (PDF)
- UnitedHealthcare Transition of Care Brochure and Application (PDF)
- UnitedHealthcare Virtual Visits (PDF)
- 2024 Employee HSA Payroll Deduction Form (PDF)
- Beneficiary Designation Form (PDF)
- Health Equity - HSA Guidebook (PDF)
- HRA - Health Reimbursement Arrangement Introduction (PDF)
- HRA Exemption Form (PDF)
- HSA - Health Savings Account Introduction (PDF)
- HSA Change of Personal Information Form (PDF)
- HSA Employee Enrollment Form (PDF)
- HSA Fact Sheet - $2,000 to $4,000 Deductible (PDF)
- HSA Fact Sheet - $2,500 to $5,000 Deductible (PDF)
- HSA Mobile Phone App Overview (PDF)
- HSA Reimbursement Form (PDF)
- Important Health Insurance Information (PDF)
- Investing Your HSA (PDF)
- Member Electronic Transfer of Funds Form (PDF)
- HealthEquity Mistaken_HSA_Distribution_Form
- Benefit Overview Police Basic (PDF)
- Benefit Overview Police Enhanced (PDF)
- Benefit Overview Public Works Basic (PDF)
- Benefit Overview Public Works Enhanced (PDF)
- Benefit Overview Town Hall Non-Rep Basic (PDF)
- Benefit Overview Town Hall Non-Rep Standard (PDF)
- Delta Dental - Student Documentation Form (fillable) (PDF)
- Delta Dental Enrollment Form (Fillable PDF)
- UHC Benefit Summary (VH115) (PDF)
- UHC Out of Network Form (PDF)
- UHC Vision Contact Lens Selection List - Children (PDF)
- UHC Vision Contact Lens Selection List (PDF)
- UHC Vision Enrollment Form (fillable) (PDF)
- UHC Vision Hearing Aid Discount (PDF)
- UHC Vision How to Print ID Card (PDF)
- UHC Vision Laser Discount (PDF)
- UHC Vision Maternity Vision Benefits (PDF)
- UHC Vision On-Line Flyer (PDF)
- UHC Vision Provider Network (PDF)
- UHC Vision Warby Parker Vision Flyer (PDF)
- UHC Vision Welcome Brochure (PDF)
Important Health Insurance Information (PDF)