Page 18 - Work Force January 2025

EBF members: Use your copayment reimbursement benefit
We’re here to ensure you are aware of the incredible benefits available to you through the CSEA Employee Benefit Fund.
If prescription drug and/
or physician copayment reimbursements are part of your negotiated collective bargaining agreement, take advantage of these valuable benefits that reimburse you annually for copayment incurred throughout the calendar year. The deadline for the 2024 calendar year for all EBF reimbursement benefits is March 31, 2025.
Prescription Drug Copayment Reimbursement for NYS employees If you’re enrolled in the New York
State Health Insurance Program (Empire Plan or health maintenance organization), you are entitled to reimbursement once annually, allowing one claim per family per calendar year.
When your copayments hit $200, the next $400 in eligible prescription drug copayments becomes reimbursable. Missed the $600 mark by Dec. 31, 2024? Not to worry – submit your claim for what you
did pay over $200. The submission deadline is March 31, 2025.
Prescription Drug Copayment Reimbursement for NYS Liquidation employees
State Liquidation Bureau members enrolled in the New York State Health Insurance Program can benefit
from an annual reimbursement opportunity. When your copayments reach $300,
the next $100
in eligible prescription drug copayments is up for reimbursement. Missed the $400 target by Dec.
31, 2024? Simply
submit your claim for what you paid over $300 before the deadline on March 31, 2025.
Unified Court System Combined Copayment Benefit for full time and retiree members
The Unified Court System benefit reimburses all out-of-pocket medical expenses not covered by health
insurance, up to $400. This includes copayments and deductibles
for both prescription drugs and medical visits. Your claim can be a combination of prescription drug and/or physician copayments maximizing your reimbursement to the full $400. Submit your claims for the 2024 calendar year by March 31, 2025.
Local Government Copayment Benefit
Local government employees
with negotiated prescription drug or physician
copayment reimbursement benefits, connect with our Member Services Department or refer to your collective bargaining agreement to understand the level and type of reimbursement available for you. The deadline for the 2024 calendar year is March 31, 2025.
How to submit a claim
Visit our website at cseaebf.com and navigate to the “Download Forms” section to get the necessary forms. If eligible, submit the applicable claim form along with supporting documentation by March 31, 2025. For prescription drug copayment reimbursements, attach a complete itemized pharmacy printout. For physician copayment reimbursements, attach the Explanation of Benefits (EOBs) from your health insurance carrier. Mail your completed claims to:
CSEA Employee Benefit Fund P.O. Box 516
Latham, N.Y. 12110-0516
Claims are not accepted via fax or email. If you have questions about these benefits, call EBF’s Member Services Department at 1-800-323- 2732.
Unleash the full potential of your benefits – act now and ensure you make the most of what your CSEA membership has to offer!
New 2025 Empire Plan benefit cards
Empire Plan enrollees and dependents will soon receive new Empire Plan health cards.
In compliance with federal law, new Empire Plan
health cards reflecting updated 2025 plan
year information will be mailed to all Empire Plan enrollees and dependents.
The new benefit
cards will include
information such
as out-of-pocket
copayments, out-of-
network annual deductible
and out-of-pocket maximums, as well as network out-of-pocket maximums (updated for 2025).
Empire Plan enrollees can
begin using the new benefit cards immediately and securely shred or destroy all other cards. Enrollees
do not need to activate this card before use.
Questions regarding receipt of the new
cards can be addressed through
your agency’s health benefits administrator
(HBA) or the Business
Services Center (BSC). HBAs and
BSC communicate directly with the Empire
Plan Administrator, the New York State Department of Civil Service Employee Benefits Division.
CSEA’s $10,000 Accidental Death Benefit
This valuable benefit is available to you as a member in good standing, at no cost to you! Since the program began in 2014, this benefit has helped nearly 120 families recover from a sudden, tragic accidental loss.
• Covers accidental deaths occurring on or off the job.
• Be sure to complete the beneficiary form, so this benefit goes to who YOU designate.
• Completing the form will ensure we have your most current information in the event of a claim.
As a CSEA member, you are covered at no cost to you.
Designate a beneficiary today!
Go to cseany.org/10KAD
or scan QR code to fill out the beneficiary form online, or download and print the form.
Return completed forms to: CSEA Insurance Department 143 Washington Ave.
Albany, NY 12210
Questions? Call CSEA’s Insurance Department at 1-800-342-4146.
18 The Work Force
January 2025