Resources

The following are forms for the City of Norwalk's employee benefits programs:

Cancer Screening Form and Memo Dental Claim Health Savings Account (HSA) Distribution Request/Account Closure Form Emergency Room Copayment Waiver Request Anthem Claim Form

CVS/caremark Mail Order CVS/caremark Prescription Reimbursement/Coordination of Benefits Claim Form Anthem Provider Lookup  Provider Attestation Form (HEP) LiveHealth Online - Telemedicine Medical & Psychology Flyer

To obtain more  UnitedHealthcare forms please visit their website and click on Tools & Resources tab AND/OR CT Partnership Plan 2.0 website.
To obtain more CVS/caremark forms please visit their website. 

For More Information

For more information about these forms, please contact the Personnel and Labor Relations Department at (203) 854-7716/7864