Optical Claim Form

Optical Claim Form


The Supplemental Benefit Fund (SBF) does not participate and will not make payment to anyone except the member of the BTF. Therefore, the member is responsible for 100% payment to the optician. After full payment has been made to the optician, mail the completed claim form to the BTF-SBF office for reimbursement. If you have any questions, please contact the SBF at (716) 881-5462.

 

 optical claim

 

Click on the Image Above to Open and Print the Supplemental Benefit Fund Optical Claim Form

 

For more information regarding the SBF Optical Benefits, please see the Optical Plan Information Section.