FORMS

Welfare

2022 Welfare Plan Summary of Benefits & Coverages

Letter to Dental Providers (Patient Claim Procedure)

Summary of Privacy Practices

Authorization to Release Information Form

Coverage Rights Under Cobra

ULLICO Life Insurance Beneficiary Form

Important Information regarding Prescriptions

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Pension

Pension Plan Summary Plan Description

Pension Direct Deposit Authorization Form

Pension Death Beneficiary Designation Form

2023 Annual Funding Notice

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Supplemental

Supplemental Retirement Plan Summary Plan Description

In-Service Withdrawal/Rollover Form

Supplemental Death Beneficiary Designation Form

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Other Benefits

Rochester Homebuyer Services Grant Assistance Programs

$10,000 ESL First-Time Homebuyer Grant

NeighborWorks Community Partners Down Payment & Closing Cost Plus Loan

Wage & Benefits Sheet - June 30, 2022, to June 4, 2023

Wage & Benefits Sheet - June 5, 2023, to May 31, 2024

Asbestos Exposure & Construction Workers Fact Sheet