Getting the Most Value from Your Negotiated EBF Benefits - 2021 Benefits Fair Tompkins County
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2021 Benefits Fair Tompkins County:
CSEA Employee Benefit Fund:
Getting the Most Value from Your Negotiated
EBF Benefits
PRESENTED BY:
Gina Tralongo
Where can you find our info?
The EBF website
www.cseaebf.com
Click on the Member
Portal Link to Make an
Account!
Member Portal
CSEA Employee Benefit Fund
“What Can I Do in the Portal?”
View/Print EBF ID Cards 1
Add/Remove Dependents
2 Upload birth certificates,
marriage certificates, and more.
Check Subscriber Information
Verify and update your e-mail, 3
phone number, and address.
View Plan Brochures
4 Brochures are for your specific
dental/vision plans.
Download a HIPAA Form 5
05
6 View/Print Dental Claims
W W W . C S E A E B F . C O M
Did you know???
Dependent Eligibility Extended to
Age 26
Effective July 1, 2020, the CSEA Employee
Benefit Fund Board of Trustees (EBF) approved
dental and vision coverage for all eligible
dependents up to age 26.
Eligible dependents include a member’s biological
children, step-children, and any other dependent
the member has custody/guardianship of such as
a grandchildren.
W W W . C S E A E B F . C O M
HOW TO:
Make the most of your DENTAL plan
W W W . C S E A E B F . C O M
DENTAL PLANS
KNOW YOUR PLAN
ANNUAL MAXIMUMS, COVERED SERVICES, PRE-DETERMINATIONS & the CALENDAR YEAR
CSEA EBF Dutchess Dental Plan has an annual
maximum of $3500 per Calendar Year.
*KNOW YOURS*
A list of the most common covered services are
outlined in your dental plan summary description.
Pre-determinations can help you and your dentist
co-ordinate treatment plan(s) to prevent going
over your annual maximum within a calendar year.
Pre-determinations are recommended for any
treatment plans exceeding $500. They provide the
member and dentist with an overview of
covered services and any potential out-of-pocket.
W W W . C S E A E B F . C O M
DENTAL PLANS
Make the Most of your
Benefits
Being asked to pay?
Ask what and why?
Use a Flex Spending Account
(if available)
Maximize your Preventative Care
3 cleanings & exams/year
Arrange expensive work to “straddle” a new
benefit year
Work with your dentist to schedule work, as needed
W W W . C S E A E B F . C O M
DENTAL PLANS
MAKE THE MOST OF YOUR BENEFITS
DENTAL IMPLANTS
• $1,000 per Implant Body
• $250 per Implant Abutment
• Crown covered by Participating
Provider as Payment in Full
W W W . C S E A E B F . C O M
DENTAL PLANS
USE
A PARTICIPATING
PROVIDER
Your Benefits • Your Choice
How can I find a participating provider?
Can I use a non-participating provider?
W W W . C S E A E B F . C O M
DENTAL PLANS
>70% PROVIDER
PARTICIPATION
PARTICIPATING PROVIDER
Agree to the CSEA EBF Fee Schedules for ALL plans as Payment in Full for covered services
Saves you and your family hundreds, if not thousands of dollars in dental costs
The SAME providers participate with our active and retiree dental plans
W W W . C S E A E B F . C O MDENTAL PLANS
PROVIDER
PARTICIPATION
NON-PARTICPATING PROVIDER
Do NOT agree to accept all CSEA EBF Fee Schedules as payment in full
Can Balance Bill for the difference between our fee schedule and their service charges
May require that you submit for reimbursement
W W W . C S E A E B F . C O MHOW TO:
Make the most of your VISION plan
W W W . C S E A E B F . C O M1. Calendar Year
2. Standard Progressive
Lenses
3. Split Benefit
W W W . C S E A E B F . C O MWhat does your CSEA EBF Platinum
12 Vision Plan offer?
Annual Exam & Glasses
(or a start-up supply of contact lenses)
Lens options include:
Plastic, polycarbonate, or glass.
Bifocals, trifocals, cataract lenses,
fashion tints, a scratch guard coating
& standard progressive lenses.
Fixed co-pays for lens upgrades
and coatings
Plan contacts include:
Soft daily, weekly, bi-weekly,
or monthly planned replacement
or disposablesTop Ten Vision FAQs
What does my vision plan cover?
How can I save money by reducing out of pocket expenses when I go in for my eye exam?
Is the retina scan (opto-mapping) covered with my plan?
What IS opto-mapping?
Is Lasik eye surgery covered?
What frames are covered under my plan?
Are there different lens options?
Do I need to use a participating provider?
What contact lenses are covered by my plan?
Are my dependents eligible?VISION PLANS
MAKE THE MOST OF YOUR BENEFITS
Use Resources:
www.cseaebf.com
(800) 323-2732
LiveChat
Know E-mail
Be
Your Most plans, excluding State, Practical
Plan reset every January.
Dependent Eligibility:
Dependents are covered until
age 26 regardless of
student/marital status
Split benefit:
You may visit one provider for
your eye exam and a different
provider for your hardware.VISION PLANS
MAKE THE MOST OF YOUR BENEFITS
What frames are covered?
What lenses/contact lenses are
covered?
Is the retina scan covered?
What are the benefits of the retina
scan?
ASK
Is Lasik eye surgery covered under
QUESTIONS my EBF plan?
Can I use my flex-card to cover any
additional costs?VISION PLANS
MAKE THE MOST OF YOUR BENEFITS
Use a network provider
www.cseaebf.com
Reduce or eliminate costs by
staying within plan
limitations
Annual exam, 1 pair of glasses
or start-up supply of contacts
Be Adding extra lens options or
choosing a designer frame?
Practical Ex. Transition Lenses,
Polarized Lenses, Gucci
Frames, etc.
You will almost certainly
experience additional out-of-pocket
for these upgrades.VISION PLANS
MORE FRAMES?
1
TIMMINA TOOTH
1. Use your EBF ID# to Create an
CSEA MEMBER
Account
2. Sign In (If you aren’t
automatically)
3. Click “Exclusive Collection”
W W W . C S E A E B F . C O MFixed Co-Pay Lens Options:
STANDARD ANTI-REFLECTIVE COATING
A coating that improves the vision and appearance of eyeglasses by
providing wearers with a reduction in glare. Anti-Reflective coating is
helpful when driving after dark and working on a computer.
ULTRA-VIOLET COATING
A coating applied to plastic lenses to block up to 99% of damaging UV
rays via exposure to the sun, TV, and computer screens. Too much
exposure can result in eye damage including cataracts and retinal
damage.
HIGH INDEX LENSES
Plastic or polycarbonate lenses which are 20-25% thinner and lighter
than conventional lenses. Their lighter weight makes them more
comfortable to wear.
POLARIZED LENSES
Two lenses laminated together which effectively block glare. Often
used in sunglasses to eliminate the glare from reflective surfaces such
as water, snow or the road’s surface.
PLASTIC PHOTOSENSITIVE LENSES
A plastic lens which gradually darkens in sunlight to provide comfort
and convenience. Also known as Transition®, or photochromic lenses.VISION PLANS
RETINA SCAN
SHOULD I GET THIS SERVICE?
Retina Scanning
This allows eye doctors to see signs of eye
diseases that they couldn't see before and
is often used in place of dilation.
Benefits:
• captures a 200° high-resolution image
of the retina in a single shot allowing
doctors a wider viewing area than
dilation alone.
• No dilation required
• Takes only a few minutes to perform
• Results are immediateLog onto
https://davisvision.com/members/
Click on “Laser Vision Correction” to see
more information about Lasik Eye Surgery
and what discounts may be available to you
TIP
You can also check with your general Health Benefits
provider to see if Lasik eye surgery is covered.
Every benefit plan is different, but it never hurts to
ask!CONTACT US
We are Social!
Like us & Share!
Facebook: @CSEAEBF
Instagram: @cseaemployeebenefitfund
Show us why you love your Union and CSEA
EBF! Snap a pic at a membership meeting or
conference with one of our representatives and
tag us to share!THANK YOU
CSEA MEMBERS!
The EBF has agreements with 647 local
government groups, representing 156,500
members. An additional 118,000 members are
covered as employees of NYS
This totals around 275,000 members and their
families
Since its establishment, the EBF has paid out
more than $1.5 BILLION in benefits to CSEA
members and their familiesW W W . R O A R A . C O M
1 Lear Jet Lane, Suite One
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