BENEFITS AT A GLANCE
You are automatically enrolled for the benefits provided by the FUSE Welfare Fund. You should have completed a Beneficiary Designation Card and be certain that it is kept current with any changes in beneficiary information including phone numbers and addresses. You, as the participant/member, may decide to use your Medical Reimbursement and Vision Benefit (the vision benefit is once per family per year, except for children prior to age 19) for your eligible spouse or child in any given year.
ENROLLMENT:
In order to properly enroll your eligible dependents, you must fill out the Dependent Enrollment Form at the time you enroll for coverage (during the month of September). During this period, members may add or drop your eligible dependents or spouses. It is the member’s responsibility to insure that the correct amount is deducted from the October 15th paycheck. Members are required to report any discrepancies to the Fund Manger within 3 business days of the October 15th paycheck. Failure to report any errors may result in excess payments or denied coverage.
As an active member of the New Rochelle FUSE, you and your dependents are eligible to participate in the following benefit plans:
Dental Benefits
Members are covered at no cost to them, dependent/spousal coverage available at additional cost. The FUSE Welfare Fund provides you with dental benefits that are self-insured and administered by Administrative Services Only. Your spouse, domestic partner, and eligible dependent children are eligible for dental benefits if you enrolled them for dental benefits and are having payroll deductions for them. A Fee Schedule detailing all benefits is available from the FUSE office or here.
Optical Benefits
Standard vision examination and eyewear such as eyeglasses or contact lenses – one individual per family per year, plus pediatric vision benefit for children prior to age 19, if enrolled in supplemental coverage members are covered for one visit and one pair of eyeglasses or contact lenses for each calendar year. Dependents under the age of 19 are entitled to enhanced vision benefits. Lasik surgery allowance of $280.00 – one individual per family per lifetime.
PEDIATRIC VISION BENEFIT For Children Prior to Age 19 Who Are Enrolled in the Dental Plan Through Self-Pay:
Children younger than age 19 who are enrolled in the dental plan through self-pay, are eligible for one eye exam and one set of glasses covered up to the Plan’s current dollar limits as shown in the vision benefit schedule (accessible at http://www.nrfuse.com). A lens prescription change is required in order to obtain a new pair of glasses within the same calendar year. Contacts are not covered, unless a letter from an ophthalmologist or optometrist is received by ASO stating that such contacts are medically necessary.
Hearing Benefits
Members are covered at no cost to them, dependent/spousal coverage available at additional cost. The FUSE Welfare Fund provides you with hearing benefits that are self-insured and administered by Administrative Services Only. Your spouse, domestic partner, and eligible dependent children are eligible for hearing benefits if you enrolled them for benefits and are having payroll deductions for them. A Fee Schedule detailing all benefits is available from the FUSE office or here.
Medical Reimbursement
The Medical Reimbursement Benefit provides eligible Participants with an annual maximum of $500 per family for the reimbursement of expenses that are generally not reimbursed by the health plan, such as co-payments, co-insurance and other eligible expenses. You must submit a claim for reimbursement of eligible expenses. All claims for benefits must be postmarked no later than March 31st of the following year. It is the member’s obligation to prove that a claim was mailed on time. You may wish to consider using certified mail.
ASO/SIDS
ASO or Administrative Services Only and its sub division SIDS (Self Insured Dental) is the third party administrator that processes all Dental, Vision, Hearing an Medical Reimbursement claims for the Welfare Fund. Each member has the ability to log onto their website and create a user name and password. Claims can then be uploaded, seen or printed by the member. The ID number needed to activate the member’s Telemedicine Account can also be located. (the ID number begins with the letters NRT)
UNUM Term Life Insurance
$50,000 Term Life Insurance is automatically provided for all active members only. The proceeds of this benefit will be paid a]er the Fund Office receives proof of your death. This insurance benefit is paid for by the Welfare Fund and provided by the first UNUM Life Insurance Company. The benefit is payable only to your beneficiary on record at the Welfare Fund Office. Please make sure your beneficiary information is updated and current. Changes can be made at any ‘me by contacting the Welfare Fund Office. The amount of the benefit is reduced to $32, 500 at age 70 and to $25,000 at age 75. This benefit is discontinued upon the member’s retirement or termination. Please note the highlights of this benefit.
Stacey Braun Financial Counseling Program
The Trustees of the New Rochelle FUSE Welfare Fund has voted to provide it’s Members with the Stacey Braun Financial Counseling Program (Program), endorsed by NYSUT Members Benefits. It is provided at no cost to our members. Click on the link above to get more information.
***PLEASE NOTE – THE NEW ROCHELLE FUSE WELFARE FUND NO LONGER CARRIES A LONG-TERM DISABILITY INSURANCE PLAN.