Admin

Current Employees


ESS Tutorial for Open Enrollment
Below is a list of forms for existing employees. Click a link to go directly to a particular form. All forms are in adobe Acrobat (PDF) format.

Use the "Tab" key to move between fields while completing a form. please complete the form and sign where required prior to mailing or faxing. If you fax the form, please mail the hard copy so that we have your original signature.

Our mailing address is:

         Norwalk Public Schools
         Attention: HR / Talent Office
         125 East Avenue
         Post Office Box 6001
         Norwalk, CT 06852-6001

Our fax number is: 203-854-4095

Please excuse any link errors while this page is being renovated. Contact burrd@norwalkps.org with questions.  Thank you.  Employee Self Service
  ESS Tutorial for Open Enrollment
   ESS Qualifying Life Event
   
Life, Dental, Vision
FMLA
AETNA Beneficiary Designation Form
FMLA for Employee
 
FMLA for Spouse/Family
DELTA DENTAL ENROLLMENT FORM FMLA for Military
Delta Dental Claim Form FMLA Poster
IPI Dental Claim Form FMLA Employee Guide 2018
   
   
   
 
Norwalk BOE - Vision Benefit Summary  
ANTHEM ENROLLMENT-MEMBER CHANGE FORM FSA (Flexible Spending Account)
Anthem Claim Form - Vision ONLY FSA Plan Description 2018
FSA Eligible Expenses 2018
  FSA Enrollment Form 2018
Tax FSA Reimbursement Form 2018
Affadavit Federal 1040 Tax Form Dependent Confirmation

Health Insurance Information

State 2.0 Plan Brochure
State 2.0 Partnership Plan
State 2.0 Presentation
State 2.0 Health Discount Program
State 2.0 Oxford Healthy Bonus          State 2.0 Clinical Programs
Connecticut 2.0 Insurance Roll-Out Information State 2.0 HEP for Partnership Plans
State 2.0 Enrollment Form State 2.0 HEP Preventive Requirements
Instructions to Print Connecticut 2.0 Cards   CVS Prescription Factsheet
State 2.0 Member Change Form    CVS Caremark - Prescriptions          
   
Union Contracts Miscellaneous Forms
NASA Contract 2015-2018 Personal Day Request
BOE - NASA Agreement 20170722 Request for school sponsored field trip
NFT Contract 2016-2019 Visiting or Professional Day Request
NFT - BOE Agreement 20170829 Teacher Evaluation Professional Learning Plan
NFT MOA re SPED Case Managers  
NFT MOA re Extended Day and Time  
HCE Nurse's Contract 2016-2019 Holiday and Weather Related Closings
ESG Contract 2016 - 2019 School Building/Office Holiday Schedule for 2017-2018
UFT Technician's Contract 2016-2019 Weather Related Closings 20180322
UPSEU Contract thru June 30, 2020 2018-2019 NPS Office Holiday Schedule
NFEP Local 1723 2013-2017  
Food Service Contract, Expired 2016