Benefits Information
Ameritas
Announcement Letter
Dental Claim Form
Vision Claim Form
The Empire Plan
The Empire Summary of Benefits and Coverage is available at https://www.cs.ny.gov/sbc/pa/index.cfm.
If you do not have internet access, call 1-877-769-7447 and select Option 1 for the Medical Program to request a copy.
Access to search for participating providers
Health Claim Form
Life Insurance
Designation of Beneficiary