Member Resources/Forms

Additional Member Benefits Information

Benefit Fund Enrollment

• New/Change Member Enrollment Form

Benefit Fund Website

• Benefit Funds Website Information

EmpiRX

• Welcome to Your EmpiRx Health Prescription Benefit – FAQ
• EmpiRx Health Member Portal

Independence Blue Cross

• IBC Find a Doctor
• IBC Discounts flyer
• IBC Get connected
• Vision Benefits flyer

Delta Dental

• Delta Dental Benefit Plan Highlights
• Delta Care FAQ
• Delta Dental PPO Overview
• Delta Dental App – Stays Connected

Disability

• Disability Benefit Plan (non-NJ)
• How to file for Disability (non-NJ)
• Disability Benefit Plan (NJ) (coming soon)
• How to file for Disability (NJ) (coming soon)

Pension

• Pension Estimate Request
• Electronic Direct Deposit
• Change Of Information

Additional Adobe Fillable Forms

• Beneficiary Form for Death Benefit
• Medicare Reimbursement Form
• Disability IRS Form W4-S 2021