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DRBA Retirees
  • Eligibility
  • Health Plans
    • Pre-65 Retiree Health Plan
    • Post-65 Retiree Health Plan
  • Other Valuable Benefits
    • Retiree Dental
    • Retiree Vision & Hearing
    • Retiree Life Insurance
    • Retiree Perks
      • Credit Union
      • Discount Program
  • Pension Payors
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    • Contacts & Resources
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Forms Library

Retirees

Forms Library

This is a list of forms that are available for benefits mentioned on this benefits site. Click on the form name to open the form.

Pre-65 Retiree Forms:

Highmark Claim Form

Express Scripts Claim Form

All Retiree Forms:ย 

Delta Dental Claim Form

EyeMed Vision Claim Form

Retiree Data Change Form

Unum Beneficiary Designation Form

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Links and Documents

  • 2026 Aetna MAPD ANOC DRBA
  • 2026 DBRA Summary of Benefits
  • CDC Immunization Schedules
  • HM SBC EPO Coverage 2026
  • HM SBC PPO Coverage 2026
  • Medicare Basics
  • Medicare IRMMA
  • my Social Security
  • DRBA 2026 Pre-65 Retirees Benefits Guide
  • DRBA 2026 Post-65 Retirees Benefits Guide
  • Retiree โ€“ Change Request Form 2026
  • Unum 2026 Beneficiary Form
Benefits Disclaimer

This Benefits Website provides general information for our benefit eligible employees; however, more detailed information is available within the plan documents and legal contracts between our company and the insurance providers. In case of any discrepancy between this Benefits Website and the plan documents, the plan documents always govern and determine your exact benefits. In addition, the company reserves the right to modify or terminate any benefit plan at any time. Benefits are not a guarantee of employment.

ยฉ2025 Omega Benefits, Inc. www.omegabenefits.net
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