State Benefits

Click here to download the State Booklet

State Vision Plan

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

This includes:

If you choose to get eyeglasses, there are select lenses and frames covered under the plan:

If you choose to get contacts:

Plan contacts consist of soft planned replacement or disposable lenses. You are allowed $25 toward non-plan contacts. For plan contacts, a contact lens formulary is used which allows for an initial supply of the most popular and commonly prescribed brands of soft contact lenses. For non-plan contacts, the $25 allowance will be applied toward the total cost of the contacts. Please note that the duration of the initial supply may vary depending on the lens type, wearing habits and prescribing doctor’s instructions regarding replacement schedule.

State Dental Plan

The State Dental plan is offered for a CSEA-represented bargaining unit that has negotiated with your employer for Fund coverage. There is a $3,000 a year annual maximum on dental benefits available to each member and dependent(s). Orthodontic benefits are available for eligible dependents under the age of 19. Whenever the estimated cost of a recommended dental treatment exceeds $500, we recommend that your dentist submit to the EBF for a pre-authorization before the work begins. A pre-authorization is not a guarantee of benefits. Payment is always subject to eligibility at the time of service.

COBRA

If you become ineligible for Fund coverage because of retirement, termination, layoff, leave without pay or reduction in hours, you may have certain rights to continue Plan coverage through COBRA.

If you die, or become divorced or legally separated, or a dependent ceases to be a dependent, your spouse and/or dependent has certain rights to continue Plan coverage through COBRA. In the event of divorce, legal separation or a child losing dependent status, you or a family member must inform the Fund of the qualifying event within 60 days of the event or the date on which coverage would be lost because of the event.

Prescription Drug Co-Pay Benefit

Download Co-Pay Form Here

Reimburses NYSHIP prescription drug card co-pays and covered prescriptions less than the co-pay once annually up to a maximum of $300 per family*, per calendar year. To obtain the maximum benefit of $300, members must wait until their co-pay expenses reach $600 before filing a claim.

*For purposes of the Prescription Drug Co-pay Benefit, “Family” includes Domestic Partner.

 

What is the benefit?

Submit your completed form with itemized pharmacy printout clearly indicating the co-pay amount, prescription drug name and patient information. Once the claim is processed the EBF will then send the check to the member. Please allow up to 6 weeks for processing.

Cash register receipts, cancelled checks and credit card receipts are not acceptable.

Charges for “over the counter” drugs, prescriptions not covered by your prescription plan, vaccines/injections, brand/generic differentials and medical supplies are not reimbursed.

Prescriptions must be dispensed by a licensed pharmacist.

Workplace Security

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.

Benefit Payable:

Level One - Assault in the 1st Degree; $10,000 for incidents involving injuries or fractures requiring a stay of 2 consecutive nights, or an incident of rape for the covered employee. There is no overnight stay required for rape.

Level Two - $2,000 for assaults other than 1st Degree or fractures requiring a stay of 2 consecutive nights in the hospital for the covered employee.

Level Three - $500 for all other incidents.

What is the Benefit?

Criminal assaults while in pursuit of his/her occupational duties and resulting in at least 10 consecutive workdays absent from work immediately following the incident.

How to File A Claim Under This Benefit


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