Hr ben 2026

1. Click ‘Get Form’ to open it in the editor.
2. Begin by filling out Section 2 - Employee/Retiree Information. Enter your full name, BSC ID, agency, and contact details including phone numbers and email.
3. In Section 3 - Declaration, provide your date of birth, retirement date, disability date (if applicable), and health insurance provider. Ensure all statements are accurate before signing.
4. If claiming a spouse, complete Section 4 with their name, SSN, date of birth, Medicare Part B date, and signature.
5. Finally, in Section 5 - Authorization, sign and date the form to authorize the Social Security Administration to share necessary information with the MTA Business Service Center.
6. Review all sections for completeness. Attach copies of your Medicare card and Form SSA-1099 before submitting.

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