Mahopac Teachers Association Benefit Fund
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FORMS NEEDED FOR ENROLLMENT:
  1. ​MTABF Enrollment & Change of Life Form ***
  2. Dental Enrollment Announcement 
  3. Dental Enrollment ***
  4. Claim Form (only if enrolling dependents in dental)  ***
  5. Dental Claim Form ​
  6. Dental Providers 
  7. Vision Enrollment ***
  8. Vision Benefit Assignment Authorization Form
  9. Hearing Aid Benefit Assignment Authorization Form
  10. Life Coverage Info Letter 
  11. Life Insurance Enrollment & Change of Beneficiary ***
  12. I Have Life Insurance  ​
  13. Financial Counseling Summary
  14. Legal Overview Information ​​​
  15. Major Medical Reimbursement 
  16. Important Contacts Info 
  17. Benefits Booklet 
 *** These forms & documentation must be returned via inter-office mail to Charles Jensen at the Middle School or mail  to:
MTABF
P.O. Box # 656
Baldwin Place, NY 10505 

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Mahopac Teachers Association Benefit Fund
P.O. Box # 656
Baldwin Place, NY 10505
​
Phone: 845.543.7415


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  • Home
  • Blog
  • Accountability
  • Dental
  • Financial
  • Hearing
  • Leave
  • Legal
  • Life
  • Major Medical
  • New Hire
  • NYSUT
  • Preferred
  • Retire
  • Variable
  • Vision