Department of
Human Resources
Madison, Connecticut
8 Campus Drive, Madison, CT 06443
Monday - Friday, 8:30 a.m. - 4:00 p.m.

Agreement between the Town of Madison & The United Public Service Employees Union

For information regarding your Anthem Blue Cross Blue Shield coverage, you can request information on your summary plan document by calling 800-233-4947 and providing your Subscriber number (located on your card).

Anthem Rx Direct Order Form

Anthem Claim Form

Enrollment & Membership Change form

COBRA Notification Letter

Bluecare Option 1 - Description of Benefits

BlueCare Vision

Century Preferred - Vision Care Plan

3 Tier Prescription Drug Program

Generic Select Program

Salary Reduction Agreement

Payment in Lieu of Benefits

FMLA Brochure (Overview of FMLA)

Notice of Obligations - Outline of the Obligations of Employees Who Take FMLA

Employee Request for FMLA Form

Life Insurance Enrollment & Change Form

Retirement Plan Summary - For the Employees of the Town of Madison, CT

Beneficiary Designation Form