Mahopac Teachers Association BeneftiT fund

P.O. Box # 656
Baldwin Place, NY 10505
Phone: 845.543.7415

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To:  All New MTA, UPSEU, Custodial & Managerial Confidential Hires

1. To understand what benefits are available to you, read through this page.
2. Return all *** items to your building trustee or to the MTABF PO Box address listed on the forms, along with marriage & birth certificates for spouse & dependents within ONE WEEK of hire date.
3. If you need additional help enrolling, please contact  your building trustee.

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ENROLLMENT /CHANGE of STATUS

1. ​***MTABF Enrollment & Change of Status Form

DENTAL

1. Dental Enrollment Announcement 
2. ***Dental Enrollment
3. Claim Form (Return only if enrolling dependents in dental ***)
4. Dental Claim Form ​​​

LIFE INSURANCE

1. Life Coverage Info Letter 
2. ***Life Insurance Enrollment & Change of Beneficiary 
3. I Have Life Insurance  ​

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VISION & HEARING:

1. ***Vision Enrollment
2. Vision Benefit Assignment Authorization Form
3. Hearing Aid Benefit Assignment Authorization Form

FINANCIAL PLANNING & LEGAL

1. Financial Counseling Summary
2. Legal Overview Information ​

CLAIMS & CONTACTS

1. Claim Form​
2. Important Contacts Info ​​

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Please be advised that it is YOUR RESPONSIBILITY​ to keep the MTABF informed of all the changes in YOUR life.
​Failure to do so could result in the loss of YOUR benefits.

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