benefit trust

The MVTA Benefit Trust currently offers dental, vision, and life insurance to all of its members. The membership consists of teachers, counselors, and administrators. The Board of Trustees has one representative from each building and a representative from the MVTA Executive Committee. Below is a list of the current trustees, along with their phone extensions and email addresses. Please feel free to contact your representative if you have any questions.

Trustee Phone Extension E-mail
Mike Conklin - IS 4206 mconklin@minisink.com
Joan Connelly - HS 1232 jconnelly@minisink.com
Chris D'Angelo - MVTA 5109 cdangelo@minisink.com
John Clemmons - MS 3247 jclemmons@minisink.com
Karen Krogslund - OTIS 2142 kkrogslund@minisink.com
Kimberly McDermott - ES 4340 kmcdermott@minisink.com

All the forms listed below are in PDF format and you must have Adobe Acrobat Reader installed on your computer to read them.  To downlaod Adobe Acrobat Reader for free click here.

dental plan information


Our dental plan is administered by:

 

PGP
Website: http://www.thepreferredgroup.com
 
Phone #: (518) 641 – 0321 or (800) 573 – 7474
                when calling ask for Melanie or Marilyn  
Fax #:      (518) 641 – 0325

Click here to print a copy of our dental plan handbook.

Click here to print a copy of our Dental Claim Form


Change of Name or Address


If there is a change in your name or address, please print and fill out this enrollment form and check the “Change” box on the top. You only need to fill out the top portion of the form and sign and date the bottom. If you are changing your name you will also need to fill out a new life insurance form as well. Return completed form(s) to your building representative.

Change in Life Insurance


If you are changing your name or would like to make a change in your beneficiaries, please print and fill out this life insurance form. When you have completed the form, give it to your building representative.

Changing Between Family and Individual Coverage


Open enrollment period is during the month of September for each school year. If you are interested in changing your coverage it must be done at that time. Only people with “a change in family status” may make changes to their coverage outside of the open enrollment period. A change in family status is when a dependent needs to be added or removed due to death, marriage, divorce, birth, or adoption. Changes must be made within 90 days of the event. To change your existing coverage, complete the appropriate forms (Dental Form and Vision Form). You must also fill out a Payroll Deduction Form. If you need assistance with any of these forms, contact one of the Trustees. When you have completed all of the forms, give them to your building representative.

College Student Waiver


If you have family coverage for dental and/or vision with a dependent between the ages of 18 and 25 that is a full time college student you need to submit a College Student Waiver form. This form needs to be resubmitted every semester.


Claim Forms





 
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