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ATTENTION Retiree Self-Service will be unavailable from 6/25 to 7/5. For urgent matters, please call HR Assistance.

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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

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 – 2023 Plan Year
2023 Summary Annual Report

Retiree Information

Address Change - Contact Employee Benefits at 800-582-5056 or email or logon to retiree self service in HR Payroll.

Retiree Self Service

Instructions and Enrollment 

Once enrolled in Retiree Self Service, you can view and print your pension verification letter.