Office of Labor Relations311Search all NYC.gov websites
The Management Benefits Fund
Important Notice
Please submit your forms and documents as follows:
1) Inquiries and questions can be sent via email to the Fund
2) Forms and documents can be submitted electronically to: https://nyc-mbf.leapfile.net
Please do not submit your form/document more than once. This will only delay processing.
You will immediately receive notification stating "Success! Your file has been received" upon completion of your document upload. You will not receive a separate email confirmation.
View step-by-step instructions and video.
3) Mail completed forms/documents to:
NYC Management Benefits Fund
P.O. Box 707
Bowling Green Station
New York, NY 10274
4) Express mail forms/documents should be sent to:
NYC Management Benefits Fund
22 Cortlandt Street, 28th Floor
New York, NY 10007
Please check back periodically for updates.
MBF Program Guides, Brochures & Forms
Complete MBF Booklet
MBF Booklet Sections
- General Information
- Basic Life Insurance and AD&D
- COBRA
- Dental Benefits
- Family and Medical Leave Act (FMLA)
- Fund Eligibility and Membership
- GHI Senior Care Drug and Medicare Supplement Health Plan Rider Subsidy Benefit
- Group Universal Life (GUL) Insurance
- Health and Fitness Reimbursement Program
- Long-Term Disability (LTD) Insurance
- Retiree Medicare HMO Drug Benefits
- Special Leave of Absence Coverage (SLOAC)
- Superimposed Major Medical Plan (SMMP) Benefits
- Survivor Benefits
- Vision Care Benefits
Management Benefits Fund Forms
Young Adult Dependent Direct Pay Coverage Continuation (DPCC) Form - October 2024
COBRA Application - October 2024
ASO Dental Claim Form (for use January 1, 2023 or after)
Health and Fitness Reimbursement Claim Form
Health and Fitness Claims Reimbursement Direct Deposit Form For Retirees Only
Superimposed Major Medical Claim Form
Superimposed Major Medical Part D Form
Superimposed Major Medical Family Building Benefit Reimbursement Forrm
HIPAA Rights (MBF Only)
Lost Check Claim
To submit a claim for a lost check from the Management Benefits Fund, the Dependent Care Assistance Program, or the Health Care Flexible Spending Account Program.