Please contact Child & Family Services for employee assistance at:

Buffalo/Erie County:  (716) 681-4300
Outside of Erie County:  (800) 888-4162

Online at:  EAP.cfsbny.org

EAP Free Consultation Services
EAP Summary of Benefits

Employees are encouraged to read family and medical leaves of absence form (NFTA Policy #04-02-14).
Additional information may be found at: wagehour.dol.gov

Employee Certification Form
Family Member Certification Form
NFTA Family and Medical Leaves of Absence Request Form
NFTA Policy - Family and Medical Leaves of Absence

Dependent Care Eligibility and Claim Form

Nova Healthcare Administrators Eligibility List

Nova Flexible Spending Account Claim Form

For employees enrolled in the High Deductible Plan, the Health Reimbursement Account annual credit is $1,500 single and $3,000 family.

These are the most commonly used forms:

BCI HRA Debit Authorization Form
Health Now Claim Form
HRA Enrollment

Children’s Health Insurance Program Notice
Creditable Coverage Disclosure Notice
Notice of Grandfathered Status
Notice of Special Enrollment Rights
Women’s Health and Cancer Rights Act

During the annual open enrollment period you can utilize the following forms to enroll in dental and eye coverage:
GHI Dental enrollment
EyeMed Enrollment Form

To find a participating dental provider follow these instructions:

GHI/Emblem Health Participating Dentist Instructions

To locate a participating eye care provider (choose the Select network):
https://www.eyemedvisioncare.com/locator/locator.emvc?execution=e1s1

Complete and submit the following claim form for dental services:

Dental Claim Form

 

Improve your health and fitness with this free online resource, visit www.bcbswny.com.

Blue Cross Blue Shield Claim
Blue Cross Blue Shield Enrollment

2020 NFT Metro - 205 Plan
2020 NFTA POS 298 Plan (POS 205)
2020 NFTA PPO HDHP Plan
SBC Uniform Glossary