Active & Retired Security Benefit Fund Update

Optical / Vision Benefits
UFA No Out-of-Pocket Plan
You can quickly look up optical providers in your area that accept UFA SBF coverage via a link on the UFA website. www.ufanyc.org/security_benefit_fund/optical_provider_search.php Optical benefits provided by the SBF allow an eye examination and one pair of prescription eyeglasses for each member and each of their eligible dependents each calendar year (retirees every two calendar years), as follows: You have one year to submit a claim.
a. Covered: The benefits include a routine eye examination, glass or plastic single vision or bifocal prescription lenses and a standard frame. Contact lenses may be substituted for lenses and frame, subject to providers’ surcharges for fittings, follow-up examinations and/or materials. Surcharges, when applicable, are payable by the member. Make sure you inquire about surcharges in advance of any service.
b. Cataract Lenses (retirees only): The Retired SBF allows up to $75 towards purchase after NYC Health Plan & Medicare, etc., have paid their portions (if applicable). Send the paid bill and NYC Health Plan(s) Explanation of Benefits (EOB) to the SBF Office for direct reimbursement. You have one year to submit a claim.
c. Not Covered: sunglasses, shatter-proof lenses where requested, more expensive frames, tinting, case-hardened lenses, progressive lenses, high-indexed lenses and similar options, except as specified on the SBF optical provider listing.
d. Limits: Participating eyeglass service providers fees are paid by the SBF with no out-of-
pocket to you for eye examinations and glasses (or contact lenses) up to a maximum limit of
$60.00 per dependent each year, which is calculated as follows:
1. EyeExam— upto$l5
2. Lenses — up to $25
3. Frames— upto$20
4. Contact Lenses — up to $45
Hearing Aid Benefit
Firefighters and their eligible dependents are covered for one (1) hearing aid once every five (5) years up to a maximum of $600, upon referral of physician or audiologist. To file a Claim:
When you have purchased a hearing aid, send a copy of the paid bill and a copy of the audiologist’s report to the SBF office for reimbursement. A check will be mailed directly to the member.
You have one year to submit a claim.