Retirement 2023
UPSEU RETIREE INFORMATION
Dear UPSEU Member,
Congratulations on making the decision to move onto the next amazing phase of your life! On this page you will find:
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
Steps to Take to Ensure YOU are Properly Enrolled
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*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.)
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
- CHANGE OF STATUS FORM - update personal info. / change of status ie: new address, marry, divorce, etc
- VARIABLE BENEFIT FORM
- BENEFITS BOOKLET
- 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
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