Documents are in a PDF file format.
School of Dental Medicine:
Dental School Contacts
- Employment Questions
John Brigada
Director of Finance & Administration
Office: 860-679-4065
E-mail: jbrigada@uchc.edu
- Program Questions
Eric R. Bernstein, J.D., Ed.D.
Associate Dean for Academic Affairs
Office: 860-679-2672
E-mail: erbernstein@uchc.edu
Tax Forms
Medical/Dental/Vision
- Medical Overview
- Pharmacy Overview
- Find an In Network Provider
- Live Health Online
- Medical/Dental Out of Network Claim Form
- Prescription Reimbursement Claim Form
- Medical/Dental/Vision Summary of Benefits and Coverage
- Annual Benefit Notices
- Enrollment Application
- Waiver Form
DENTAL
VISION
Life Insurance
Disability Insurance
Discounts
Financial Information
- Direct Deposit Authorization Form
- Tax Sheltered Investment Program (403b)
- Dependent Care Reimbursement Account (Pre-tax Childcare Expense)
- Dependent Care Enrollment Form
- ADP Instructions
Student Loan Debt Information
- PSLF Employer Certification Instructions
- PSLF Certification and Application Form
- PSLF Assistance – The Institute of Student Loan Advisors Corporation (TISLA)
- PSLF Assistance – StudentLoanPlanner
- Citizens Student Lending Solutions
Counseling Programs
Plan Documents
Insurance Benefits While Traveling
Work Related Injury – Workers’ Compensation
- Dental Residents: Return completed forms to the Dental Deans Office (AG009).
Exiting Residents
COBRA
COBRA ALTERNATIVES