Benefit forms

Staff

Sub-Menu

Staff

Health Insurance

Excellus Medical Claim

2017-18 HCR Memo 22

BTD PPO H5_15_30 Rx3 Copays MO

2018 ACA Declination Letter

Health Enroll PPO Classic

Classic PPO Booklet

BTD Broome BOCES CB 100 Ded_5_15_30 Rx

2017 Broome BOCES PPOH vs CBRW 2 cov.

Young adult to age 29 B3024

BCBS change of address form

Dental Insurance

JBR05 Broome Tioga BOCES Plan D01

JBR05 Broome Tioga BOCES Plan D02

Student verification form

LBS dental enrollment

2015 LBS Dental claim form

Vision Insurance

Vision Benefit Summary - 21 pays

Enrollment form included

Vision Benefit Summary - 26 pays

Enrollment form included

Davis Vision (External Link)

Click on the "Find a Provider" link in the blue box in the upper left hand corner

VSP Vision Provider Lookup (External Link)

Flexible Spending Account

Flex voucher 2017-18

Flex voucher 2016-17

Guidelines for use of otc

Flex claims guidelines 2011

Flex brochure 1

BDT BOCES flex plan summary

Retirement

403(b) UA notice

2017 list of service providers

ERS Tier 6 booklet

TRS Handbook

TRS SS verification

TRS prior service claim

TRS name and address chg form

TRS loan form

TRS beneficiary form

Tier 6 book

Supplemental service ERS

Military service credit

ERS Tier 5 plan booklet

2017-18 ERS Loan Form

ERS change of name

ERS Change of address

ERS beneficiary form

About BOCES Management Services Instructional Programs Professional Development SCRIC CMS Created by eSchoolView

Broome-Tioga BOCES 435 Glenwood Road Binghamton, NY 13905 Phone: (607) 763-3300

PDF files require you to download Adobe Reader Here.

Broome Tioga Boces