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The NYU Benefit Plan Application form serves as a vital resource for former employees of New York University who wish to access the Portable Tuition Benefit for their dependent children. This benefit is specifically designed for the children of former full-time NYU employees, excluding those from the Medical School, who are pursuing undergraduate studies at colleges or universities other than NYU. To ensure a smooth application process, it is essential to carefully follow the provided instructions, which include reading the relevant policy on the NYU Human Resources website and completing all sections of the form. Applicants must attach an itemized bill for the current term, which should detail any scholarships or awards received. Additionally, if proof of relationship is not already on file with the NYU Benefits Office, a copy must be included with the submission. Payments are processed through EBPA, and applicants should mail the completed form to the designated address in Exeter, New Hampshire. It is crucial to submit the application before the deadlines set for each academic term to ensure timely payment to the educational institution. The form also requires specific information about the former employee, the dependent child, and their academic status, ensuring that all eligibility criteria are met. By signing the application, the former employee affirms their understanding of the policy and confirms the dependent child's status as defined by NYU guidelines.

Similar forms

  • Tuition Reimbursement Request Form: Similar to the NYU Benefit Plan Application, this form allows employees to request reimbursement for educational expenses. Both documents require proof of enrollment and detail eligibility criteria for dependents.

  • Dependent Care Flexible Spending Account (FSA) Application: This application is used to request funds for dependent care expenses. Like the NYU Benefit Plan Application, it requires documentation of expenses and eligibility verification for dependents.

  • Health Insurance Enrollment Form: This form is utilized by employees to enroll dependents in health insurance plans. Both documents necessitate proof of relationship and require accurate personal information about the employee and dependents.

  • Student Financial Aid Application: This application is used by students seeking financial assistance for their education. Similar to the NYU Benefit Plan Application, it involves submitting proof of enrollment and may have specific deadlines for submission.

  • Scholarship Application Form: This form is used by students applying for scholarships. Like the NYU Benefit Plan Application, it requires information about the student’s academic status and may require supporting documentation to verify eligibility.

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NEW YORK UNIVERSITY

PORTABLE TUITION BENEFIT PLAN APPLICATION

Questions About a Payment? Call EBPA at

1-800-578-3272

For Dependent Child of Former Full-Time NYU Employees (excluding the Medical School) Attending Undergraduate College Or University (Other Than NYU)

Administrative/Professional (100), Faculty (102), Professional Research (103)

EXCLUSIONS: The benefit does not extend to children of employees, who do not meet the eligibility requirements for retirement, disability retirement, layoff, or death. See the policy for details.

Instructions:

•Read the policy (www.nyu.edu/hr) and complete all sections of this form

•Attach an itemized bill for the current term. Bill must include any awards or scholarships received

•If you do not have proof of relationship on file in the NYU Benefits Office, attach a copy of the proof to this form (see policy at www.nyu.edu/hr for details including required proofs)

•Payments are processed by EBPA. Mail form to: EBPA, Reimbursement/FSA, PO Box 1140, ExEter, NH 03833-1140

•EBPA will mail a check to the dependent child’s college or university within 3 weeks of receipt of a properly completed application and documentation. This application must be submitted in time to meet the deadline for payment at the dependent child’s school. Each school has a different schedule for payments.

•Applications will be accepted by EBPA beginning July 1st but must be received no later than:

November 30th for the fall term

February 28th for the winter term

April 30th for the spring term

September 30th for the summer term

•If you have questions about a payment to a school, call EBPA at 1-800-578-3272

Former NYU Employee Information

Last name

 

First name

 

 

SSN

 

 

 

 

 

 

 

Residence address

 

City

 

State

Zip

 

 

 

 

 

 

Home telephone (include area code)

 

Month/Year of Separation from NYU

 

(__ __ __) __ __ __ - __ __ __ __

 

 

__ __ / __ __ / __ __ __ __

 

 

 

 

 

Check former employee’s classification:

 

 

 

Faculty (102)

Professional Research Staff (103)

Administrative & Professional Staff (100)

If a spouse (or same sex domestic partner) is currently employed by NYU or meets the eligibility rules as a retiree, or lay off, provide the following information:

Last name

First name

SSN

 

 

 

Dependent Child Information (Information in this section relates to the dependent child who is a full-time student matriculated for an undergraduate degree attending an accredited college or university, other than NYU)

Last name of dependent child

 

First name of dependent child

 

SSN of dependent child

 

 

 

 

 

Name of undergraduate institution

 

 

Date of birth of dependent child

 

 

 

______/______/__________

 

 

 

Date this dependent child began undergraduate study

Application is for academic year 20__ – 20__; payments should be made by:

______/______/__________

semester

trimester

quarter

 

 

 

The dependent child named above is a dependent of the former NYU employee and is (check one)

 

the biological child

the legally adopted child

 

 

the stepchild, who is the biological or adopted child of my current spouse

 

 

the biological or adopted child of my registered same sex domestic partner (under current IRS regulations benefits paid to such a child would be taxable to the former NYU employee)

Former Employee’s Statement By this application, I acknowledge that I have read in full the NYU policy governing portable tuition benefits on the HR website certify that the person named on this application is a dependent child as defined in the policy and is matriculated in an undergraduate degree program at an accredited college or university other than NYU.

Former Employee’s Signature

 

Student Signature

 

Date

 

 

 

 

 

 

 

 

 

 

 

 

Common mistakes

Filling out the NYU Benefit Plan Application form can seem straightforward, but many people make common mistakes that can delay their benefits. One frequent error is not reading the policy thoroughly before starting the application. The policy contains essential information about eligibility and requirements that can save time and prevent confusion later. Ignoring these details can lead to incomplete applications, causing unnecessary delays in processing.

Another mistake often made is failing to include an itemized bill for the current term. This bill must show any awards or scholarships received. Without this documentation, the application may be rejected or delayed. It’s crucial to double-check that all necessary attachments are included before sending the form. Missing paperwork can result in the application being returned or not processed at all.

Many applicants also overlook the importance of providing proof of relationship if it is not already on file with the NYU Benefits Office. This proof is vital to confirm the dependent child's eligibility for the benefit. If this step is skipped, it can lead to complications and additional requests for information, further prolonging the process. Always ensure that all required documentation is attached to the application.

Lastly, some people submit their applications too close to the deadlines set by EBPA. Each school has different payment schedules, and if the application is not received on time, benefits may not be processed in time for the dependent child’s school payments. It’s wise to submit the application well ahead of the deadlines to ensure everything is in order and to avoid any last-minute issues.

More About Nyu Benefit Plan Application

  1. What is the purpose of the NYU Benefit Plan Application form?

    The NYU Benefit Plan Application form is designed for the dependent children of former full-time NYU employees (excluding those from the Medical School) who are attending an accredited undergraduate college or university other than NYU. This form allows eligible dependents to apply for tuition benefits as outlined in NYU’s policy.

  2. Who is eligible to apply for benefits under this plan?

    Eligibility extends to the dependent children of former NYU employees who meet certain criteria, including retirement, disability retirement, layoff, or death. Children of employees who do not meet these eligibility requirements are excluded from the benefit.

  3. What documents must be submitted with the application?

    Applicants must complete all sections of the form and attach an itemized bill for the current term, which should include any awards or scholarships received. If proof of relationship is not already on file with the NYU Benefits Office, a copy of the necessary documentation must also be included.

  4. How and where should the completed application be submitted?

    Once completed, the application should be mailed to EBPA at the following address:
    EBPA, Reimbursement/FSA,
    PO Box 1140,
    Exeter, NH 03833-1140.

  5. What is the processing time for the application?

    EBPA will process the application and mail a check to the dependent child’s college or university within three weeks of receiving a properly completed application and the necessary documentation. It is crucial to submit the application in time to meet the payment deadlines set by the dependent child’s school.

  6. When can applications be submitted, and what are the deadlines?

    Applications can be submitted starting July 1st. However, they must be received by EBPA no later than the following deadlines:

    • November 30th for the fall term
    • February 28th for the winter term
    • April 30th for the spring term
    • September 30th for the summer term

  7. What if I have questions about a payment?

    If you have inquiries regarding a payment to a school, you can call EBPA at 1-800-578-3272 for assistance.

  8. What information is required about the dependent child?

    The application requires specific information about the dependent child, including their full name, Social Security Number (SSN), date of birth, name of the undergraduate institution, and the date they began their undergraduate studies. Additionally, the application will ask for the academic year and payment schedule (semester, trimester, or quarter).

  9. What should I do if my spouse or partner is also employed by NYU?

    If a spouse or same-sex domestic partner is currently employed by NYU or meets the eligibility criteria as a retiree or laid-off employee, their information must be provided on the application. This includes their full name and SSN.

Misconceptions

Understanding the NYU Benefit Plan Application form can be challenging. Here are some common misconceptions that may arise:

  • Only current employees can apply. Many believe that only current NYU employees are eligible for the benefit. However, former full-time employees can also apply for their dependent children.
  • The benefit is available for any college. Some think that the benefit can be used at any college or university. In fact, it is specifically for accredited institutions other than NYU.
  • All dependent children qualify automatically. There is a misconception that all children of former employees qualify for the benefit. Eligibility depends on specific criteria, including the employee’s retirement status and the child’s enrollment status.
  • Proof of relationship is not necessary. Many assume that no documentation is needed to prove the relationship to the dependent child. However, if proof is not already on file, it must be submitted with the application.
  • Applications can be submitted at any time. Some individuals think they can submit applications whenever they want. Each term has a specific deadline that must be adhered to in order to receive benefits.
  • Payments are sent immediately upon application. There is a belief that payments will be processed as soon as the application is submitted. In reality, it can take up to three weeks after receipt of a properly completed application.
  • Scholarships do not need to be included. Some applicants think they can submit bills without detailing any scholarships or awards received. The application requires an itemized bill that includes this information.
  • All types of dependents are treated the same. There is a misconception that all dependents, regardless of their relationship to the employee, are eligible for the same benefits. Different rules apply based on whether the child is biological, adopted, or a stepchild.
  • The application process is the same for all terms. Many believe that the application process does not vary by term. Each academic term has its own deadlines and requirements that must be followed.

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Key takeaways

Filling out the NYU Benefit Plan Application form requires attention to detail. Here are key takeaways to ensure a smooth process:

  1. Understand Eligibility: The benefit is specifically for dependent children of former full-time NYU employees who meet certain criteria.
  2. Read the Policy: Before completing the form, read the NYU policy on portable tuition benefits available at www.nyu.edu/hr.
  3. Complete All Sections: Ensure every section of the application is filled out completely to avoid delays.
  4. Attach Required Documents: Include an itemized bill for the current term, showing any awards or scholarships.
  5. Proof of Relationship: If necessary, attach proof of relationship documentation to the form.
  6. Mailing Instructions: Send the completed form to EBPA at the specified address to ensure proper processing.
  7. Know the Processing Time: Payments are typically processed within three weeks of receipt of a complete application.
  8. Be Aware of Deadlines: Submit the application by the deadlines for each term: November 30th for fall, February 28th for winter, April 30th for spring, and September 30th for summer.
  9. Contact for Questions: If you have questions about payments, call EBPA at 1-800-578-3272 for assistance.

Following these takeaways can help streamline the application process and ensure that benefits are received in a timely manner.

Nyu Benefit Plan Application: Usage Guide

Completing the NYU Benefit Plan Application form is an important step in securing educational benefits for a dependent child. To ensure that the application is processed smoothly and efficiently, it is essential to follow the outlined steps carefully. Here is a straightforward guide to assist you in filling out the form correctly.

  1. Begin by reviewing the NYU policy regarding the Portable Tuition Benefit Plan available at www.nyu.edu/hr.
  2. Fill in the former NYU employee information. Provide the last name, first name, Social Security Number, residence address, city, state, zip code, and home telephone number.
  3. Indicate the month and year of separation from NYU, including the classification of the former employee (Faculty, Professional Research Staff, or Administrative & Professional Staff).
  4. If applicable, provide information about a spouse or same-sex domestic partner currently employed by NYU or eligible as a retiree or laid off employee.
  5. Next, complete the dependent child information section. Include the last name, first name, and Social Security Number of the dependent child, as well as the name of the undergraduate institution and the date of birth.
  6. Specify the academic year for which the application is being submitted and indicate the preferred payment schedule (semester, trimester, or quarter).
  7. Confirm the relationship of the dependent child to the former employee by checking the appropriate box (biological child, legally adopted child, stepchild, or child of a registered same-sex domestic partner).
  8. Attach an itemized bill for the current term, ensuring it includes any awards or scholarships received.
  9. If proof of relationship is not on file with the NYU Benefits Office, include a copy of the necessary documentation.
  10. Review the application for accuracy and completeness.
  11. Sign and date the application, both the former employee and the dependent child must provide their signatures where indicated.
  12. Mail the completed application and all attachments to EBPA at the address provided: EBPA, Reimbursement/FSA, PO Box 1140, Exeter, NH 03833-1140.

After submitting the application, it is advisable to keep a copy for your records. Payments will be processed by EBPA, and checks will be mailed directly to the dependent child's college or university within three weeks, provided the application is complete and submitted on time. Be mindful of the payment deadlines specific to each academic term.

⇓ Nyu Benefit Plan Application PDF