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1871. Infertility Treatment & Procedures Disclosure Form - Connecticut

  INSTRUCTIONS: CONNECTICUT INFERTILITY TREATMENT AND PROCEDURES DISCLOSURE FORM     Connecticut individuals seeking health insurance coverage for infertility treatment and procedures are required to file a form disclosing any ...

1872. External Review Application Form - Connecticut

  INSTRUCTIONS: CONNECTICUT REQUEST FOR EXTERNAL REVIEW     A Connecticut patient who has been denied health insurance coverage for a procedure may request an external review from the state's Insurance Department by using ...

1873. External Review Consumer Guide - Connecticut

1874. CT Surety Liquidation Claim Form - Connecticut

  INSTRUCTIONS: CONNECTICUT PROOF OF CLAIM (SURETY LIQUIDATION)     This article discusses a proof of claim form that was made available following the liquidation of the Connecticut Surety Corporation and related affiliates. T ...

1875. Consumer Complaint Form - Connecticut

  INSTRUCTIONS: CONNECTICUT CONSUMER COMPLAINT FORM     To file a complaint regarding denial of insurance coverage in Connecticut, use the form discussed in this article. This document can be obtained from the website of the g ...

1876. Discrimination Complaint/Federal Grants - Connecticut

  INSTRUCTIONS: CONNECTICUT DISCRIMINATION COMPLAINT/FEDERAL GRANTS     To file a complaint in Connecticut regarding discrimination by a program or activity supported by the U.S. Department if Justice, use the form discussed i ...

1877. Grievance Complaint (Supreme Court or Appellate Court) filed under the Americans With Disabilities Act - Connecticut

  INSTRUCTIONS: CONNECTICUT GRIEVANCE COMPLAINT (SUPREME COURT OR APPELLATE COURT) FILED UNDER THE AMERICANS WITH DISABILITIES ACT     Connecticut residents who believe they have been the victim of a discriminatory act or deci ...

1880. Request For Accommodation By Persons With Disabilities - Connecticut

  INSTRUCTIONS: CONNECTICUT REQUEST FOR ACCOMMODATION BY PERSONS WITH DISABILITIES (Form JD-ES-264)     To request reasonable accommodation for a person with disabilities as defined by the Americans With Disabilities act at a ...

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