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Empire Plan Summary of Benefits available online
Age-Related Macular Degeneration Awareness
The CSEA Employee Benefit Fund (EBF) is proud of its long-standing relationship with Davis Vision. This partnership enables the EBF to offer high quality vision care plans to hard working CSEA members across New York state.
EBF’s valuable vision plans cover state employees, Unified Court employees, and several local government units (towns, villages, school districts) as a part of their negotiated contracts. If you are unsure if you have coverage
with EBF, visit our website at cseaebf.com and use our benefit search tool.
February is National
Age-Related Macular Degeneration
Awareness month.
Read further to
discover more
information from Davis Vision about this impairment as well as the symptoms.
What is Age-Related Macular Degeneration (AMD)?
AMD is a disease that erodes central vision and is one of the leading causes of visual impairment and blindness for older Americans. Fortunately, new research methods are being developed that can make the management of this disease much more effective.
AMD is caused by changes in
the macular, which is located in
the retina and on the inside back layer of the eye. The macula is responsible for sharp central vision which is essential for task requiring
straight-ahead focusing, such as driving and reading.
What are the symptoms of AMD?
Symptoms of AMD consist of blurry central vision where objects my become distorted. A dark or empty area in the center of one’s visual field may appear as the disease progresses along with straight lines appearing wavy or crooked and gradual loss of color vision.
These symptoms may also indicate a condition other than AMD. If you experience any of them, contact your eye doctor as
soon as possible so they can diagnose the cause of vision impairment.
Can AMD be prevented?
A regularly scheduled comprehensive eye
exam provides the best preventive measure against AMD and its onset. Vision that has already been lost cannot be restored, although the earlier AMD is detected, the more successful treatment can be. Regular eye exams, a healthy diet and exercise are also important.
Risk factors for AMD
Age: As the name suggests, age is a major risk factor for AMD. Though it can occur earlier, the disease is most likely to occur after age 60. Smoking: Research has shown that smoking doubles the risk of AMD. Genetics: Caucasians and people with a family history of AMD are at highest risk.
The U.S. Patient Protection and Affordable Care Act requires all insurance plans to make available a Summary of Benefits and Coverage for employees eligible for benefits and potential enrollees.
The Summary of Benefits and Coverage and Uniform Glossary for The Empire
Plan and NYSHIP health maintenance organizations (HMOs) can be found online at www.cs.ny.gov/sbc.
Employees who do not
have internet access may call 1-877-7-NYSHIP (1-877-769-7447) and select the Medical/Surgical Program to request a copy of the SBC for the
Empire Plan. Your health benefits administrator, usually located in your agency’s personnel office, can also print you a copy.
The Summary of Benefits and Coverage is a simple,
standardized multi-page comparison tool that is intended to help
consumers better understand and
compare available health insurance options.
While this information may be helpful, employees should also refer to other plan
material, such as the Choices booklet and rates and deadlines flier for the most comprehensive coverage and benefit information.
Empire Plan claims deadlines for calendar year 2017
Empire Plan enrollees have until April 30, 2018, 120 days after
the end of the calendar year, to submit medical expenses which were incurred during the 2017 plan year to:
UnitedHealthcare Service Corp. P.O. Box 1600
Kingston, NY 12402-1600
For the Empire Plan Basic Medical Program, the Home Care Advocacy Program (HCAP) and for non- network physical therapy or chiropractic services.
Empire BlueCross/BlueShield NYS Service Center
P.O. Box 1407 — Church Street Station
New York, NY 10008-1407
For Empire Plan and non-network Inpatient or Outpatient hospital services.
Beacon Health Options, Inc.
P.O. Box 1850
Hicksville, NY 11802
For non-network mental health and substance abuse services.
CVS Caremark
P.O. Box 6590
Lee’s Summit, MO 64064-6590
For prescriptions filled at non-participating pharmacies or at participating pharmacies without using your New York Government Employee Benefit Card.
Enrollees can call the Empire Plan at 1-877-7NYSHIP (1-877-769-7447) with questions or to obtain claim forms. As a reminder, when using the Empire Plan’s toll-free telephone number, please pay extra attention to the choices offered by the automated system.
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 claim form, include the original billing
or receipt (if requested), and don’t forget to sign the claim form.
February 2018
The Work Force 17