Page 18 - Work Force April 2022

EBF benefits add value to CSEA membership
National Employee Benefits Day is April 5. If you have one or more CSEA Employee Benefit Fund (EBF) benefits, you have something to celebrate!
Your CSEA Employee Benefit Fund (EBF) benefits have
been designed to
improve the health
of you and your family and to save you money.
The hardworking
members who
came before you
understood the value of benefits when it comes to your compensation. If you don’t have strong benefits, it might be time to fight hard to negotiate them into your contract. Leave a legacy for future generations of CSEA members.
polycarbonate, glass, bifocals, trifocals, cataract lenses, fashion tints, standard progressive lenses and scratch guard coating. Fixed co-payments for additional lens upgrades and coatings allow member
to choose these options at a fraction of the retail cost for such features.
Plan contacts include soft daily, weekly, biweekly, or monthly plan replacement, or
disposables. There are no out-of- pocket costs for covered services at one of more than 10,000 nationwide vision providers.
All these features add tremendous value to your CSEA membership. Here are some highlights of our dental and vision benefits:
calendar year
• Orthodontia benefit for
dependent children
Vision Plan
• Includes one eye exam and one pair of glasses or a start-up supply of contact lenses every other year. Dependents are eligible every calendar year.
Unified Court System Dental Plan
• Three cleanings and exams per calendar year
• $3,000 annual maximum
• $1,000 per implant/two per
calendar year
• Orthodontia benefit for
dependent children and adults
Vision Plan
• Includes an eye exam and glasses or start-up supply of contacts once every calendar year.
Local Government Dental Plans
• $2,000-$3,500 annual maximum,
depending on plan
• $1,000 per implant/two per
calendar year (not available
with EBF Member Plus Plan) • Orthodontia benefit for
dependent children and adults (adult orthodontia available with Equinox and Dutchess plans only)
Vision Plans
• Include an eye exam and glasses or start-up supply of contacts once every calendar year.
If you are unsure which benefits you have, use our Benefit Search
tool at cseaebf.com. Select “Local Government” or “State Agency.” If you select “Local Government,” select the county of your employer, click search and then select your unit. If you select “State Agency” you will need to select your specific agency from the menu.
Still unsure? Give us a call at 800- 323-2732 or use our Live Chat feature. We are always happy to answer questions and to lend you a hand with your benefits.
Our dental plans all include
generous annual maximums,
cleanings and exams outside the
annual maximums, and no out-of-
pocket costs for covered services at
one of more than 4,000 participating providers. •
New York State Dental Plan $3,000 annual maximum
Three cleanings and exams per calendar year
$1,000 per implant/two per
All of our vision plans include lens options such as plastic,
• •
Empire Plan 2021 claims deadline is April 30
Empire Plan enrollees have until April 30, 2022 (120 days after the end of the calendar year) to submit medical expenses incurred during the 2021 plan year.
Network providers/pharmacies will submit claims directly to the appropriate insurance carrier on your behalf when provided with all necessary information.
If you have a non-network
claim submission, make sure you complete the requested subscriber information on the appropriate claim form, include the original billing
or receipt (if requested), sign and return the claim form.
Claim submission for Empire Plan Basic Medical Program, the Home Care Advocacy Program (HCAP) and for non-network physical therapy or chiropractic services:
New York State Government Employees Health Insurance Program
UnitedHealthcare
P.O. Box 1600
Kingston, N.Y. 12402-1600
OR FAX TO (845) 336-7716 Online submissions: https://nyrmo.optummessenger. com/public/opensubmit
Claim submission for Empire Plan non-network inpatient or outpatient hospital services:
Empire Blue Cross NYS Service Center
P.O. Box 1407, Church Street Station
New York, N.Y. 10008-1407 Claims submission fax: 888-367- 9788
Online Submissions: www.empireblue.com/forms/
Claim submission for Empire Plan non-network mental health and substance use services:
Beacon Health Options, Inc. P.O. Box 1850
Hicksville, N.Y. 11802
Claims submission fax: 855-378- 8309
Online submissions: www.achievesolutions.net/ empireplan
Claim submission for Empire Plan prescriptions filled at non- participating pharmacies or at participating pharmacies without using your New York Government Employee Benefit Card use:
CVS Caremark
P.O. Box 52136
Phoenix, A.Z. 85072-2136 Online submissions:
www.caremark.com. Choose ‘submit a claim’ under ‘plan and benefits.’
For any questions, call the Empire Plan toll free: 1-877-7-NYSHIP (1-877- 769-7447).
18 The Work Force
April 2022