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Excess Medical, Prescription Drug, &
​Dental forms for
INSERVICE GNTA MEMBERS

GNTA Inservice Excess Medical Benefit Claim Form
File Size: 140 kb
File Type: pdf
Download File

GNTA Prescription Drug Benefit Claim Form
File Size: 90 kb
File Type: pdf
Download File


DENTAL FORMS FOR Inservice GNTA MEMBERS & RETIREE Benefit trust members

GNTA Dental Claim Form
File Size: 758 kb
File Type: pdf
Download File

NOTE: Be sure to check with your doctor prior to any service to ensure that they are a Participating Dental Provider.
gnta_ppo_2025.pdf
File Size: 208 kb
File Type: pdf
Download File

GNTA Dental Fee Schedule
File Size: 166 kb
File Type: pdf
Download File


Excess Medical & Prescription Drug Forms for RETIREES/PARAPROFESSIONALS

GNTA Retiree/Para Prescription Drug Benefit Claim Form
File Size: 230 kb
File Type: pdf
Download File

GNTA Retiree/Para Excess Medical Benefit Claim Form
File Size: 258 kb
File Type: pdf
Download File

EXPENSE REPORT WITH UPDATED MILEAGE RATES FOR 2025

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GNTA Expense Report 2025.pdf
File Size: 106 kb
File Type: pdf
Download File

Great Neck Teachers Association
NYSUT, AFT-NEA, AFL-CIO #2686 | The Cottage • 343 Lakeville Road • Great Neck, NY 11020 
[email protected] | 
@greatneckta.bsky.social
(516) 829-9070