Benefits Forms
Health Benefit Forms
Caremark Mail Order Form
Caremark Prescription Reimbursement Form
SilverScript prescription claim form for Medicare retirees (PDF)
CIGNA Claim Form
Vision Care Claim Form
Vision Provider List
Metlife Dental Form
Retiree Health Program Enrollment/Change Form
Financial Forms
Direct Deposit
W-4P – Withholding Certificate for Pension or Annuity Payments Please email your W4 to Con Edison Payroll.
NY State Tax Withholding Explanation and Election Form
Pension Information
Annual Funding Notice – 2020 Plan Year
2019 Summary Annual Report
Retiree Information
Address Change - Contact Employee Benefits at 800-577-9527 or email orbenefitsinbox@oru.com or logon to retiree self service in HR Payroll.
Retiree Self Service
Once enrolled in Retiree Self Service, you can view and print your pension verification letter.