HR NFTA Employee Services

WELCOME TO OUR PAGE

This Employee Services page is sponsored by the Human Resources department. We hope it provides the information you need, but if it doesn't, contact us at 855-6500.

Employee Change Forms

It is very important that Human Resources has accurate information. If you have changed addresses, please fill out the change of address form and send it to HR as soon as possible. If your emergency contact information needs to be updated be sure to complete and return the emergency contact information form.

Change of Address Form 
Emergency Contact Information

If you would like to change your Federal Tax Withholding amount or NYS Tax withholding amount please complete the appropriate form and submit those to HR.

Federal withholding Allowance Form
NYS Withholding Allowance Form

EA
Employee Assistance Program
FM
Family Medical Leave Act
FS
Flex Spending
HI
Health Insurance

Employee Assistance Program - EAP

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

Family Medical Leave Act - Forms:

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

Flex Spending - List of eligible expenses & Claim Form

Nova Healthcare Administrators Eligibility List

Nova Flexible Spending Account Claim Form

Flex Spending - Dependent Care Eligibility and Claim Form

Dependent Care Eligibility and Claim Form

Health Insurance - Annual Notifications
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

Health Insurance - Summary of Benefits Coverage (SBC)
2020 NFT Metro - 205 Plan
2020 NFTA POS 298 Plan (POS 205)
2020 NFTA PPO HDHP Plan
SBC Uniform Glossary

Health Insurance - My Health

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

Blue Cross Blue Shield Claim
Blue Cross Blue Shield Enrollment

Health Insurance - High Deductible Plan Information

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

Health Insurance - Dental & Eye Information

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