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O&R Retired Employee Benefits
Benefits Forms

O&R Retired Employee Benefits

Benefits Forms

Health Benefit Forms

Caremark Mail Order Form
Caremark Prescription Reimbursement Form
CIGNA Claim Form
Vision Care Claim Form
Vision Provider List
Metlife Dental Form

Financial Forms

Direct Deposit
W-4P – Withholding Certificate for Pension or Annuity Payments
NY State Tax Withholding Explanation and Election Form

Pension Information

Annual Funding Notice – 2018 Plan Year
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.

Self Service

Self Service Instructions