PEF MBP Forms

Download any form of your choosing to gather what you need for any existing benefit/program offering.

Insurances

Assault, Trauma, & Captivity Claim Form

Beneficiary Designation Form

Beneficiary Designation Form for those with Group Term Life Insurance

Domestic Partner Affidavit

Evidence of Insurability Form (Online form)

Evidence of Insurability Form (Paper form)

Retiree Dental Enrollment Form

Financial & Legal Services

Legal Defense Claim Form

Legal Defense Release Form

Voluntary Legal Service Plan Enrollment Form (Payroll/Pension)

Voluntary Legal Service Plan Enrollment Form (mail-in)

Other

Exam Fee Reimbursement

Military Leave Form

Retiree Enrollment Form & Pension Deduction Form

Retiree Renewal & Pension Deduction Form

Retiree Spousal Enrollment Form

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Entertainment

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About

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For PEF Members

Contact

Monday-Friday, 9 a.m.-5 p.m. EST

10 Airline Drive, Suite 101, Albany, NY 12205

Due to several fraudulent activities resulting in a significant financial loss to PEF MBP, and to ensure that only active, dues-paying PEF members and retirees are able to purchase e-tickets and e-gift cards using their Membership Identification Number (MIN) and their own credit card, all purchases must now be made by calling (518) 785-1900, ext. 243, opt. 1, or (800) 767-1840, or visiting the PEF MBP office at 10 Airline Dr., Albany. This verification process helps ensure that only eligible members and retirees receive PEF MBP benefits, allowing us to maintain low costs, offer a rich selection of benefits, and increase the overall value for everyone. PEF MBP is actively seeking an alternative solution for e-ticket and e-gift card purchases and appreciates your patience as we work through this transition.