Medical Forms PDF

 

Vision and Dental Form in PDF as of 03/2015

POMCO                            Preferred Group Plans (SOA Dental & Optical)             WC Benefits
PO Box 6329                   PO Box 15136                                                                          141 Martine Ave.
Syracuse, NY, 13217       Albany, NY, 12212-5136                                                      White Plains, NY, 10606
(800) 234-4393              (518) 641-0321                                                                      (914) 995-4715

ASSURANT LIFE CLAIM FORM  For SOA Members
Use this form to update your Beneficiary for your Insurance.
10,000 up to age 65.    5,000 after age 65

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