POMCO Claim Form (PDF)

POMCO/SWSCHP http://www.swschp.org
P.O. Box 6329
Syracuse, NY 13217
1-888-779-7247

Cafeteria Plan Reimbursement Voucher (PDF)
New ALFAC Spending Claim Form
Flexible Spending Handbook
Direct Deposit Enrollment Form

IRS 125

Cafeteria Plans allow participants to pay for out-of-pocket medical expenses, adult and child dependent care expenses and privately held medical insurances on a pre-tax basis. The plan runs from September 1 to August 31 and employees must set up payroll deductions by June 15 for the fiscal year beginning in September with payroll at the district office 914-273-4082 x5935.

Dental Claim Form (PDF)
List of Dental Providers (PDF)
Dental Vision Enrollment Form (PDF)

The following benefits are administered by the BHTA Benefit Fund. Benefit Fund Trustees are Jackie White (jwhite@byramhills.org) and Chris Rasquin (crasquin@byramhills.org) and they can be reached at 914-273-4250 X3174.

Flexible Benefits Program Claim Form (PDF)

Flexible Benefits Program reimburses employees up to $100 for out of pocket medical bills that have not been fully covered by health insurance.

This is part of the Benefit Fund so please contact Jackie White or Chris Rasquin with questions.

Vision Claim Form (PDF)
Dental Vision Enrollment Form (PDF)

Davis Vision http://idoc.davisvision.com/davis/public/default_home.htm
Vision Care Processing Unit
P.O. Box 1525
Latham, NY 12110
Phone 1-800-999-5431
Phone 1-518-220-6000

Mike Heffernan
Mirkin & Gordon - The Atrium
98 Cuttermill Rd.
Great Neck, NY 11021
1-914-997-1576

Click here to access The Teachers Legal Fund

UPDATED: August 22, 2011