Here's where you will find the forms you may need for ATA benefits. Please contact your building representative if you can't find the form here, and drop me a note so I can put up a copy for the future.
In addition to Dental Benefits provided by the ATA Welfare Trust through our Administrator, Preferred Group Plans, Inc., other benefits are provided to all members at no cost as described below:
Vision Care - Our Vision Care program provides benefits to ATA Members (who are properly enrolled) for any expenses incurred for vision related care. A maximum benefit of $300. is payable for the fiscal period beginning October 1st and ending September 30th. Claims (partial or full) may be submitted at any time during this fiscal period. Forms are available from Welfare Trust Representatives in each building and from here on the website. Claim forms along with a copy of the bill should be submitted to: Arlington Teachers' Association, c/o Preferred Group Plans, Inc., PO Box 15136, Albany, NY 12212-5136 for payment. Claims must be received no later than three months following the end of the fiscal period for which the expense was incurred.
Personal Health Care - Our Personal Health Care program provides benefits to ATA Members (who are properly enrolled) for any expenses incurred for unreimbursed medical claims or prescription costs other than for Vision or Dental. A maximum benefit of $300. is payable for the fiscal period beginning October 1st and ending September 30th. Claims (partial or full) may be submitted at any time during this fiscal period. Forms are available from Welfare Trust Representatives in each building and from here on our website. Claim forms along with a copy ofa medical insurance claim report showing the amount of unreimbursed expsenses should be submitted to: Arlington Teachers' Association, c/o Preferred Group Plans, Inc., PO Box 15136, Albany, NY 12212-5136 for payment. Claims must be received no later than three months following the end of the fiscal period for which the expense was incurred.
If you have any questions, concerns or problems feel free to contact the Welfare Trust Representative in your building or call Ron Higgins at the ATA Office. The phone number is 845-454-7002.
Welfare Trust Medical Claim Form
Welfare Trust Vision Claim Form
Welfare Trust Enrollment/Change Form
The form required to maintain coverage for a dependent student
The dental form is here. It is now one page only.
These forms are in "PDF" format, which means they will open up Adobe Acrobat before you can print them. This ensures that they will print correctly. If you have any trouble, try installing the proper plugin from Adobe. Because of their size and complexity, the dental forms may take a minute or two to download to your computer. Set your printer to high resolution, and it should print better than it looks on screen.
Information about the flex plan, which lets you use pre-tax dollars to help with medical and child care expenses can be found at www.thepreferredgroup.com.