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Human Resources and Affirmative Action

Forms

Benefits
Forms & Internet Resources

Dental Plan Forms:

Carrier Group of Employees
UUP Benefit Fund/Delta Dental UUP
CSEA Benefit Fund* CSEA
GHI Dental* M/C, C.82, PEF, GSEU

Vision Plan Information:

CSEA Benefit FundCSEA800-323-2732
Davis VisionUUP800-887-3863
EyeMed Vision CareM/C, C82, PEF, GSEU877-226-1412

Retirement System Forms:

NYS Employees' Retirement System*ALL

Membership application
Retirement application
Change of address form (active members only)

NYS Teachers' Retirement SystemUUP, M/C
Optional Retirement Systems Carriers: ING, MetLife, Valic, TIAA-CREFUUP, M/CContact Human Resources for various forms
Tuition Assistance Contact Human Resources for various forms

Other Benefits Forms:

» Leave Donation Form*



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