Mahopac Teachers Association Benefit Fund
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Retirement 2023

INFORMATION FOR: MTA, MANAGERIAL CONFIDENTIAL & CUSTODIAL SUPERVISOR MEMBERS


​Dear MTA Member,

Congratulations on making the decision to move onto the next amazing phase of your life!

​On this page you will find:
  1. All the forms you need to transition to retirement. 
  2. A brief VIDEO PRESENTATION about the plans.
We recommend you view the VIDEO PRESENTATION with the EXPLANATION of PLAN CHOICES  in front of you

RETIREE “TO DO” CHECKLIST
​
Steps to Take to Ensure YOU are Properly Enrolled
RETIREMENT PLAN CHOICES

EXPLANATION of PLAN CHOICES - 2 types of coverage
  • COBRA ENROLLMENT FORM​*
​OR
  • MTABF PLANS ENROLLMENT FORM*​
Picture
View this video to get some quick insight into Benefit Options. Having the Explanation of Plan Choices in front of you is suggested.
*CHANGE OF  STATUS FORM * -  We must have this back & you will use it in the future to update personal information / change of status ie: new address, marry, divorce, etc
DENTAL - ​ (For those who are choosing as part of a plan the following are important forms. Those with a *red star* must be returned with your enrollment papers.)
  • DENTAL ENROLLMENT PLAN OPTIONS  - explains how to enroll spouse &/or dependents
  • DENTAL ENROLLMENT FORM FOR SPOUSE / DEPENDENTS - use to enrolling spouse &/or dependents
  • DENTAL CLAIM FORM - use to get reimbursed for dental expenses
  • DENTAL COVERAGE SCHEDULE - amounts covered for dental procedures
  • DENTAL PROVIDERS - list of providers who take MTABF dental, but you can use your own
LIFE INSURANCE - (For those who are choosing as part of a plan the following are important forms. Those with a *red star* must be returned with your enrollment papers.)
  • LIFE INSURANCE COVERAGE INFORMATION 
  • LIFE INSURANCE CHANGE OF BENEFICIARY FORM*
  • I HAVE LIFE INSURANCE DECLARATION - put with your w
​VISION  - (For those who are choosing as part of a plan the following are important forms. Those with a *red star* must be returned with your enrollment papers.)
  • VISION ENROLLMENT - use to allow coverage of spouse &/or dependents*
  • VISION BENEFIT AUTHORIZATION FORM - use to allow spouse or dependent to use instead of you
ADDITIONAL OPTIONAL BENEFITS - (For those who are choosing as part of a plan the following are important forms. Those with a *red star* must be returned with your enrollment papers.)
  • HEARING AID BENEFIT AUTHORIZATION FORM - use to allow spouse or dependent to use instead of you
  • FINANCIAL COUNSELING BENEFIT SUMMARY 
  • 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. BENEFITS BOOKLET 
  4. IMPORTANT CONTACT INFO 
GIVE FORMS & CHECK to YOUR BUILDING TRUSTEE
or
​MAIL TO:

MTABF
c/o C. JENSEN
39 Grace Lane
Pleasant Valley, NY 12569


NEW RETIREES DO NOT MAIL ENROLLMENT FORMS & CHECK TO PREFERRED.
BUILDING TRUSTEES 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 - Andrea D'Aprile
  • High School - Eileen Clements
  • High School - Jacqueline Lividini

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  • Home
  • Accountability
  • Blog
  • Dental
  • Financial
  • Hearing
  • Hired
  • Leave
  • Legal
  • Life
  • NYSUT
  • Preferred
  • Retire
  • Variable
  • Vision