Go to Benefit Forms
Open Enrollment Info Session Resources
Excellus BCBS Health Insurance:
2022 Info Session Recording Password: 35h9&!@T
2022 Slides
2021 Info Session Recording Password: mw5k$5zL
2021 Slides
ProAct Pharmacy:
2022 Info Session Recording Passcode: XsU6sR&P
2022 Slides
2021 Slides
ProAct Core Tiered Formulary List
www.CanaRx.com (CanaRx) Login: GTCMHIC
CanaRx Covered Medications List
CSEA Dental and Vision:
2022 Info Session Recording (awaiting recording from CSEA EBF)
2022 Slides (awaiting slides from CSEA EBF)
2021 Info Session Recording Password: vWcB8k*f
2021 Slides
Benetech FSA and HRA:
2022 Info Session Recording Passcode: TLwiN%2D
https://Benetech.lh1ondemand.com
New York State Deferred Compensation
ESI EAP (Employee Assistance Program)
Traditional EAP Info Session Recording Passcode: +A^ZT^@9
Public Safety EAP Info Session Recording Passcode: P0o+r@sP
NYS 529 College Savings Program
Schedule a 1:1 meeting with our Account Manager, Melissa Kapsiak, HERE.
General Benefits Info Session
2022 Info Session Recording Passcode: nt$jIi6K
2022 Slides
Retiree Benefits Info Session
2022 Info Session Recording Passcode: ck0$XFFE
2022 Slides
Benefit Forms
- Bereavement Form
- Bereavement Policy
- EAP (Employee Assistance Program) Information
- Excused Leave
- Fitness Program and Weight Management Reimbursement Form
- Flexible Spending Account/Health Reimbursement Account (VEBA)
- Health Insurance Waiver
- IT2104 Form (NYS Tax withholding form) - Please send completed form to Payroll
- Medical Leave
- Medical/Prescription Insurance
- Military Leave Policy
- Military Leave of Absence Form
- NYS Deferred Compensation Plan
- NYS Retirement
- Retiree Health Insurance Information
- Reasonable Accomodation Policy
- Reasonable Accommodation Request Form - ADA Accommodation
- Reasonable Accommodation Request Form - Religious Accommodation
- Reasonable Accommodation Request Form - Domestic Violence Accommodation
- Student Loan Forgiveness
- W-4 Form (Federal Tax withholding form) - Please send completed form to Payroll
FLEXIBLE WORK SCHEDULE INFORMATION
Appendix A - Request for Flexible Work Schedule Form
Appendix B - Flexible Work Schedule Agreement
TELEWORK AGREEMENT INFORMATION
Appendix A - Request for Telework Arrangements
Appendix B - Telework Agreement
Appendix C - Telework Weekly Log