Health & Benefits

Use these links and forms to resolve any questions or concerns relative to annuities, benefits, or pension. If you need any additional assistance contact the PBA office.
   
NYSHIP EMPIRE PLAN 1-877-769-7447
COLE VISION PLAN 1-800-638-0166
EMPIRE PLAN MANAGED CARE 1-800-922-1213
MTA DENTAL BENEFITS 1-800-942-0854
MTA PENSION DEPARTMENT 1-212-878-7004
MTA DEFERRED COMP 1-212-878-7311
FLEXIBLE SPENDING ACCOUNT 1-877-924-3967
     
EMPIRE PLAN COLE VISION  
METLIFE DENTAL MTA DEFERRED COMP  
     

(click on the icon to download the PDF files. You will need Adobe reader to print them)
Front

Group Basic Accidental Death & Dismemberment Insurance

Enrollment / Change Form for MTA Police
Front Dependent Life Insurance Enrollment / Change for MTA Police
Front Vision Care out of network claim form

2 Sided

 Health Insurance claim form (2 sided form, front and back)
2 Sided MTA Headquarters Dental Expense claim form (2 sided, front and back)
Front Employee Expense Form
2 Sided 20 Year Police retirement program of the MTA defined benefit pension plan, Designation of Beneficiary with contingent beneficiaries
Front Workers Compensation Board, statement of rights
Front Change of Address Form
Front MTA 401K Plan, Beneficiary Designation
Front MTA 457 Deferred Compensation Plan
2 Sided John Hancock Life Insurance Instructions
2 Sided John Hancock Life Insurance Withdrawal - Eligible for Rollover

2008 © MTA PBA