EBF Local Government Employee

Local Government Benefits

The EBF provides benefits to more than 600 CSEA represented local government units, including counties, cities, towns, villages, school districts and public authorities. The EBF has considerable experience in dealing with the complexities that surround local government negotiations which is why we offer varying levels of dental, vision and reimbursement benefits. All plans are obtained through contract negotiations or by a memorandum of agreement between a CSEA bargaining unit and its employer. Refer to your contract or use our Benefit Search Tool to find out exactly what EBF benefits you have.

Click on the tabs below to view highlights and associated forms for our various Local Government Benefits.

Local Government Vision Benefits

EBF vision plans provide members and their eligible dependents to an eye exam, a pair of lenses and frames, or an initial supply of contact lenses, once per calendar year. Standard progressive lenses and scratch resistant coating are included at no charge. Members using a participating provider pay no out-of-pocket expenses provided they stay within the plan lens and frame collection.

Our Silver, Gold, and Platinum Vision Plans are available for Local Government CSEA units.

Silver Plan

Download the Silver Plan Booklet
The Silver Vision Care Plan offers quality services at no cost to the members within the designated plan when using a participating provider.

This includes:
  • Routine eye exam. This includes dilation if professionally indicated.
  • Eyeglasses OR contact lenses.
  • You are allowed one full service (exam and eye wear) each calendar year.
If you choose to get eyeglasses, there are select lenses and frames covered under the plan:

Covered Lenses include Standard single vision, bifocals and trifocals, and Standard progressive-addition lenses. Scratch proofing is covered on plan lenses.

The frame collection includes a large selection in multiple styles and is updated periodically. If you opt for a frame that is not part of the collection, you will be given a $75 allowance from the plan and you must pay the difference to the provider.

If you choose to get contacts:

Plan contact lenses consist of Soft Standard Daily Wear, Planned Replacement or Disposables. A contact lens formulary is used which allows for an initial supply of many of the most popular and commonly prescribed brands of soft contact lenses. If specialty (non-plan) contact lenses such as Toric, Multifocal or Rigid Gas Permeable lenses are required, the allowance will be applied toward the total cost of the contact lenses. You are allowed $75 toward non-plan contact lenses.

Gold Plan

Download the Gold Plan Booklet
The Gold Vision Care Plan offers quality eye care services at no cost to members within the designated plan from one of the Plan's panel providers.

This includes:
  • Routine eye exam. This includes dilation if professionally indicated.
  • Eyeglasses OR contact lenses.
  • You are allowed one full service (exam and eye wear) each calendar year.
If you choose to get eyeglasses, there are select lenses and frames covered under the plan:

Covered Lenses include Standard single vision, bifocals and trifocals, and Standard progressive-addition lenses. Scratch proofing is covered on plan lenses.

The frame collection includes a large selection in multiple styles and is updated periodically. If you opt for a frame that is not part of the collection, you will be given a $75 allowance from the plan and you must pay the difference to the provider.

If you choose to get contacts:

Plan contact lenses consist of Soft Standard Daily Wear, Planned Replacement or Disposables. A contact lens formulary is used which allows for an initial supply of many of the most popular and commonly prescribed brands of soft contact lenses. If specialty (non-plan) contact lenses such as Toric, Multifocal or Rigid Gas Permeable lenses are required, the allowance will be applied toward the total cost of the contact lenses. You are allowed $125 toward non-plan contact lenses.

Occupational Benefit:

The Gold Vision Care Plan includes the Occupational Benefit and is available to members only. The occupational benefit entitles the member to an occupational eye exam, which may result in the member being prescribed two pairs of glasses, a dress pair and one to be used for work. To receive occupational glasses the prescription must be different than the dress pair or include a tint. The exception to this rule is that members who drive will be entitled to a prescription pair of sunglasses even if the prescription is the same as their regular glasses. The Participating Provider makes the determination whether the occupational pair is warranted. The occupational glasses must be done at the same time that you are getting your first set of eyewear.

Platinum Plan

Download the Platinum Plan Booklet
The Platinum Vision Care Plan offers quality eye care services at no cost to members within the designated plan from one of the Plan's panel providers.

This includes:
  • Routine eye exam. This includes dilation if professionally indicated.
  • Eyeglasses OR contact lenses.
  • You are allowed one full service (exam and eye wear) each calendar year.
If you choose to get eyeglasses, there are select lenses and frames covered under the plan:

Covered Lenses include Standard single vision, bifocals and trifocals, Photo gray lenses (Glass), Blended invisible bifocals and trifocals, Standard progressive-addition lenses, Premium progressive-addition lenses, and Prescription sunglasses. Scratch proofing is covered on plan lenses.

The frame collection includes a large selection in multiple styles and is updated periodically. If you opt for a frame that is not part of the collection, you will be given a $75 allowance from the plan and you must pay the difference to the provider.

If you choose to get contacts:

Plan contact lenses consist of Soft Standard Daily Wear, Planned Replacement or Disposables. A contact lens formulary is used which allows for an initial supply of many of the most popular and commonly prescribed brands of soft contact lenses. If specialty (non-plan) contact lenses such as Toric, Multifocal or Rigid Gas Permeable lenses are required, the allowance will be applied toward the total cost of the contact lenses. You are allowed $125 toward non-plan contact lenses.

Vision Plan Options

The following Vision Plan Options can be added to our Optical programs.

  • Standard Anti-Reflective Coating - A coating which allows a much higher percentage of light to pass through the lens. May be purchased separately under the Silver, Gold and Platinum Plans.
  • High Index Lenses - Glass or plastic material which results in a lens that is 20-25% thinner. May be purchased separately under the Silver, Gold or Platinum Plans.
  • Polarized Lenses - Lenses which effectively block glare. Especially useful near water or snow. May be purchased separately under the Gold or Platinum Plans.
  • Plastic Photosensitive Lenses - Plastic Lenses that darken when exposed to light. May be purchased separately under the Platinum Plan.
  • Ultra Violet Coating - A coating applied to any lens material to block up to 100% of potentially harmful UV light. May be purchased separately under Silver, Gold and Platinum Plans.
  • Occupational Vision - This benefit is available to members only. The occupational benefit entitles the member to an occupational eye exam, which may result in the member being prescribed two pairs of glasses, a dress pair and one to be used for work. To receive occupational glasses the prescription must be different than the dress pair or include a tint. The exception to this rule is that members who drive will be entitled to a prescription pair of sunglasses even if the prescription is the same as their regular glasses. The Participating Provider makes the determination whether the occupational pair is warranted. This option may be purchased separately under the Platinum Plan. The occupational glasses must be done at the same time that you are getting your first set of eyewear.

Vision Discount Fixed Co-Pays

This valuable program provides savings to members resulting in less out-of-pocket for "add ons".

Major Plan Features:

  • Program offers fixed co-pays for lenses and coatings at any EBF participating provider office.
  • Members/eligible dependents who wish to purchase lenses and coatings not currently covered by their vision program will be entitled to a set co-pay, resulting in substantial out-of-pocket savings.

Fixed Co-pays Include:

Vision Feature
Platinum
Gold     
Silver  
Standard Anti-Reflective Coating $35.00 $35.00 $35.00
Premium Anti-Reflective Coating $48.00 $48.00 $48.00
Ultra Anti-Reflective Coating $55.00 $55.00 $55.00
Ultimate Anti-Reflective Coating $85.00 $85.00 $85.00
Ultra Violet(UV) Coating $12.00 $12.00 $12.00
Plastic Photosensitive Lenses $65.00 $65.00 $65.00
High Index Lenses $55.00 $55.00 $55.00
Polarized Lenses $75.00 $75.00 $75.00
Premium Progressive Addition Lenses $0.00 $90.00 $90.00
Ultra Progressive Addition Lenses $50.00 $140.00 $140.00
Ultimate Progressive Addition Lenses $175.00 $175.00 $175.00

How to Use This Benefit

  • Use any CSEA Employee Benefit Fund participating vision provider. To search for affiliated providers, Use our Provider Search Tool.
  • Members who choose lenses and/or coatings not covered in their existing EBF vision plans will pay the fixed co-pay in the schedule listed above.

Limitations And Exclusions

  • Member must be covered by EBF under existing vision program to be eligible for fixed co-pay(s).
  • This discount is available only at the time of your regular CSEA EBF service. It is not available as a separate service outside of your eligibility date.

Local Government Dental Benefits

EBF group dental plans include coverage for diagnostic, preventive, basic and restorative, endodontics, periodontics, prosthodontics, oral surgery, orthodontics, and an allowance towards the cost of implants.

These plans also include coverage for three exams and three cleanings per calendar year. Covered exams and cleanings are paid outside the plan maximum.

Participating providers accept most plan payments as full payment for covered services. There are no deductibles or co-payments in or out of our provider network. Non-participating providers will balance bill between what the plan pays and what their office charges.

Our Sunrise, Horizon, Equinox, and Dutchess Dental Plans are available for Local Government CSEA units.

Sunrise Plan

Download the Sunrise Plan Booklet
The Sunrise Dental Plan offers a $2,850 per person annual maximum on regular dental work.

Horizon Plan

Download the Horizon Plan Booklet
The Horizon Dental Plan offers a $3,000 per person annual maximum on regular dental work. The fee schedule is higher than the Sunrise schedule.

Equinox Plan

Download the Equinox Plan Booklet
The Equinox Dental Plan offers a $3,210 per person annual maximum on regular dental work. The fee schedule is higher than that of the Sunrise and Horizon schedules. The Equinox Plan also covers adult orthodontics which is not currently covered under the Sunrise and Horizon Plans.

Dutchess Plan

Download the Dutchess Plan Booklet
The Dutchess Dental Plan is our premiere plan and offers an annual maximum of $3,500 per person for regular dental work. Dutchess reflects higher fees when compared to most Equinox services. The Dutchess plan also covers adult orthodontics.

Participating Providers

Participating providers have agreed in writing to accept the CSEA EBF Fee Schedule as payment in full for services covered by our dental plans. However, if a member requires treatment from a specialist in a participating general dentistry practice, he/she will be informed of the specialist's right to balance bill. The member will be responsible for the difference between the specialist's customary charge for the service and the allowance which the CSEA EBF pays under the member's dental plan. Members choosing a non-participating dentist are reimbursed according to the fee schedule which appears in the Summary Plan Description provided to the member. Although our recruitment process of providers into the EBF is ongoing, participation is at the sole discretion of the dentist.

Specialists

Oral Surgeons, Endodontists, Periodontists who are part of participating general practices have the right to bill members the difference between the specialist's customary charge for the speciality service and the allowance paid by the applicable CSEA Employee Benefit Fund dental plan.

How to Use This Benefit

Use any CSEA Employee Benefit Fund participating dental provider. To search for affiliated providers, Use our Provider Search Tool.

The Solstice Dental and Vision Plans are now the EBF Member Plus Dental and Vision Plans.

The CSEA Employee Benefit Fund offers voluntary Dental Plans & Vision Plans to keep you healthy and save you money.

EBF Member Plus Dental

  • $2,000 per person annual dental plan maximum with orthodontic coverage for eligible dependents up to age 19.
  • This plan allows flexibility as it pays the same amount to any provider for covered services. No deductibles.
  • Participating providers agree to accept EBF payments as full payment for most services. Non-participating providers can balance bill.
Download the EBF Member Plus Dental Plan SPD Booklet

EBF Member Plus Vision

  • Yearly examination and prescription eyewear coverage
  • Members can choose from one of the following plan eyeglasses, prescription sunglasses, or plan contact lenses coverage at participating provider's office.
  • Includes the option to add lens coatings with a copay.
Download the EBF Member Plus Vision Plan SPD Booklet

Contact Information

For more information on our Member Plus plans, contact the EBF today:

Long Island Region
Candace Sclafani
631-462-5224
csclafani@cseaebf.org

Southern Region
Courtney Sim
800-323-2732 x808
csim@cseaebf.org

Capital Region
Erin Bazinet
800-323-2732 x860
ebazinet@cseaebf.org

Central Region
Andrew Miller
800-323-2732 x814
amiller@cseaebf.org
Western Region
Michael Wagner
800-323-2732 x828
mwagner@cseaebf.org

Reimbursement Benefits

The following benefit plans are also offered as negotiable benefits. These plans can be added to existing benefits in place for a unit or they may be negotiated separately as a stand-alone plan. These benefits are only offered to local government units.

Download the Hearing Aid Reimbursement Form

Provides an allowance up to $450 per ear towards the cost of a hearing aid once every three calendar years, depending on your contract. The member submits a completed claim form with the paid bill and a copy of the doctor's prescription for the hearing aid to the EBF. The member is reimbursed up to the $450 per ear maximum and charges over the allowances are the responsibility of the member. The member retains the right to choose any doctor or otologist. The Plan does not cover repairs to hearing aids or replacement batteries.

Download the Maternity Plan Reimbursement Form

Covers eligible members or their spouses. Upon the birth of a child, the plan pays a $200 benefit to help defray maternity care costs. Multiple births receive multiple benefits and this benefit is not diminished by any other medical benefit which may be received.

Download the Prescription Drug Reimbursement Form

Reimburses co-pays and other out-of-pocket costs for prescription drugs which are not covered by the member's regular prescription drug plan once annually, up to a maximum of $200 per family per calendar year. Other maximums and/or benefit years may be negotiated. Prescriptions must be dispensed by a licensed pharmacist. Drugs, vitamins, diet supplements, etc., which can be purchased without a prescription are not covered.

Download the Physician Copay Reimbursement Form

Reimburses health insurance co-payments for office visits. Reimbursement is processed once annually up to a maximum of $120 per family per calendar year.

All CSEA members in good standing who are covered by the Employee Benefit Fund for one or more benefits are automatically enrolled in this program at no cost to the member or employer. Administered by Pearl Insurance, this program insures the member for trauma experienced during specific incidents while in pursuit of their occupational duties; i.e., criminal assault on the job, hostage situations, and accidental death related to an assault. There are specific benefit amounts paid dependent upon conditions explained in the program booklet.