| Benefit Plan |
Form |
Document |
For all Plans |
|
|
401(k) Plan |
- Deferred Salary Plan Direct Deposit (PDF, 96K)
- Deferred Salary Plan Benefit Application (PDF, 76K)
- Deferred Salary Plan Medical and Dental Record (“Form A”) (PDF, 14K)
- Deferred Salary Plan Prescription and/or Over-the-Counter Drug Record (“Form B”) (PDF, 17K)
- Beneficiary Designation (PDF, 20K)
- Important Beneficiary Information (PDF, 70K)
- Landlord Affidavit (PDF, 8K)
- Deferred Salary Plan Coordination of Benefit Payments (PDF, 50K)
- Deferred Salary Plan Application For Wage Replacement Day and Picket Duty Benefits (PDF, 13K)
- Deferred Salary Plan Picket Duty Confirmation Form (PDF, 10K)
- Street Lighting Division - Wage Replacement/Inclement Weather Application For Benefits (PDF, 75K)
|
|
Additional Security Benefits Plan |
|
|
Annuity Plan |
|
|
| Apprentice Program |
| |
Dental Plan |
|
|
| E.E.S.I.S.P. |
|
|
Educational & Cultural Trust Fund |
- OSHA Safety Class Registration (PDF, 19K)
- Educational & Cultural Class Offerings Registration (PDF, 61K)
- Educational & Cultural Program Information Request Form (PDF, 13K)
- Beneficiary Designation (PDF, 20K)
- Important Beneficiary Information (PDF, 70K)
- Stress Management Availability Information Form (PDF,41K)
- Scholarship Brochure Information (PDF, 3.28 MB)
- Registration Application for GED Preparation Classes (PDF, 73K)
- Conduit Bending Seminar Form (PDF, 38K)
- ESL Classes Registration Form (PDF, 19K)
- Return to College At Empire State (PDF, 765K)
- Registration Application for the 2010 Critical Thinking Weekend Seminars (PDF, 74K)
|
|
| Elevator Dental Plan |
|
|
| Employees’ Security Fund (Medical, Prescription Drug, Dental Plan and Pension) (for members of the Fixture, Manufacturing, or Supply Divisions) |
|
- Employees’ Security Fund Health and Welfare Plan SPD (PDF, 395K)
- Employees’ Security Fund Prescription Drug Benefit Handbook (PDF, 476K)
- Employees’ Security Fund of the Electrical Products Industries Pension Plan SPD (PDF, 73K)
- ESF Medical Plan Certificate of Creditable Coverage (PDF, 35K)
- Notice Of Improved Prescription Drug Coverage Effective January 1, 2009 (PDF, 320K)
- Pension Credit Increased for Active Employees (PDF, 26K)
- New Joint and Survivor Pension Options Adopted (PDF, 30K)
- Medco Savings Opportunities Newsletter (PDF, 343K)
- Health Care Advocate Brochure (PDF, 863K)
|
| Health Reimbursement Plan (HRA) |
|
|
| Legal Services |
N/A |
|
| Medical Plan (Pension, Hospitalization and Benefit Plan for the Electrical Industry) |
|
|
Pension Plan (the Pension Trust Fund for the Electrical Industry)
|
|
|
| Safety Program |
|
|
Vacation/Holiday/
Unemployment Plan |
|
|
