To submit the Statement of Claim / Medical Claim Form you can download the form from this link and submit the completed claim form to the address provided at the top of the form. You must complete and sign a Statement of Claim form at least once each year.

To submit a dental claim for processing you can download a Dental Claim Form from this link and submit completed claim form to the address provided at the top of the form.

This claim form is to be used only when it has been necessary to purchase prescriptions because your participating pharmacy did not honor your identification card or was unable to directly submit your claim. It should also be used when it was necessary to have your prescriptions filled at a non-participating pharmacy.

Please fill this form out to file a Short Term Disability report.

Please fill this form out to authorize Pension check direct deposit.

Please fill this form out to request a Pension distribution.

Please use this form to submit a Healthcare Reimbursement Account reimbursement request.

Please use this form to request an Emergency withdrawal from the Tax Deferral Plan. Both the application and IRS-W4 form must be completed and provided to the Administrative Office. The form requires a notary which cannot be waived.