UPSEU RETIREE INFORMATION

Dear UPSEU Member,

​On this page you will find:
  1. All the forms you need to transition to retirement. 
  2. A brief VIDEO PRESENTATION about the plans.
  3. Times for VIRTUAL MEETINGS where you can interact with a MTABF trustee.
We recommend you view the VIDEO PRESENTATION with the EXPLANATION of PLAN CHOICES  in front of you.

BUilding Trustees ARE VIA EMAIL

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PictureView this video to get some quick insight into Benefit Options. Having the Explanation of Plan Choices in front of you is suggested.
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  1. RETIREMENT PLANS
    1. EXPLANATION of PLAN CHOICES - Choose COBRA OR a MTABF PLAN
    2. *COBRA ENROLLMENT FORM
    3. *MTABF PLANS ENROLLMENT FORM
  2. *CHANGE OF  STATUS FORM -  update personal info. / change of status ie: new address, marry, divorce, etc
  3. DENTAL  (if you are enrolling plan)
    1. DENTAL ENROLLMENT PLAN OPTIONS  - use if enrolling spouse &/or dependents
    2. DENTAL ENROLLMENT FORM FOR SPOUSE / DEPENDENTS - use if enrolling spouse &/or dependents
    3. DENTAL CLAIM FORM - Use to get reimbursed for dental expenses
    4. DENTAL COVERAGE SCHEDULE - amounts covered for dental procedures
    5. DENTAL PROVIDERS - list of providers who take MTABF dental, but you can use your own
  4. LIFE INSURANCE (if maintaining your plan)
    1. LIFE INSURANCE COVERAGE INFORMATION 
    2. *LIFE INSURANCE CHANGE OF BENEFICIARY FORM 
    3. I HAVE LIFE INSURANCE DECLARATION - put with your will
  5. VISION  (if maintaining your plan)
    1. *VISION ENROLLMENT - use to allow coverage of spouse &/or dependents
    2. VISION BENEFIT AUTHORIZATION FORM - use to allow spouse or dependent to use instead of you
  6. HEARING AID BENEFIT AUTHORIZATION FORM - use to allow spouse or dependent to use instead of you
  7. FINANCIAL COUNSELING BENEFIT SUMMARY 
  8. LEGAL BENEFIT SUMMARY 

​IMPORTANT FORMS & DOCUMENTS FOR FUTURE USE
  1. CHANGE OF  STATUS FORM - update personal info. / change of status ie: new address, marry, divorce, etc
  2. VARIABLE BENEFIT FORM
  3. MAJOR MEDICAL REIMBURSEMENT 
  4. BENEFITS BOOKLET 
  5. IMPORTANT CONTACT INFO 
   9. RETIREE “TO DO” LIST  Steps to Take to Ensure YOU are Properly Enrolled
*Regardless of which plan you choose, you must mail in the forms with the* next to them.
PLEASE DO NOT MAIL FORMS TO PREFERRED.
GIVE FORMS to YOUR BUILDING TRUSTEE or MAIL ALL FORMS TO:
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MTABF
c/o C. JENSEN
39 Grace Lane
Pleasant Valley, NY 12569