UPSEU RETIREE INFORMATION

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​May 24, 2022 @ 4:30
​BE A PART OF VIRTUAL A MEETING THAT WILL WALK YOU THROUGH THE BENFITS YOU CAN CARRY INTO RETIREMENT  SIGN- UP HERE

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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

• Austin Road  - Tara DelMonaco
• Falls School, Bus Garage, District Office - Jay Melville
• Fulmar Road  -  Lisa Tornambe
• Lakeview  - Kate Legeret
• Middle School - Kelly Kischak
• Middle School -  Irene Arocho 
• High School - Paul Clements
• High School - Eileen Clements

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View 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. DENTAL
   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
3. LIFE INSURANCE
   1. LIFE INSURANCE COVERAGE INFORMATION 
   2. LIFE INSURANCE CHANGE OF BENEFICIARY FORM 
   3. I HAVE LIFE INSURANCE DECLARATION - put with your will
4. VISION
   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
5. HEARING AID BENEFIT AUTHORIZATION FORM - use to allow spouse or dependent to use instead of you
6. FINANCIAL COUNSELING BENEFIT SUMMARY 
7. LEGAL BENEFIT SUMMARY 

​IMPORTANT FORMS & DOCUMENTS FOR FUTURE USE

1. *CHANGE OF  STATUS FORM - update personal info - move, 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 return  the forms with the* next to them.

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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

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