Page 15 - Teamsters Local 237
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Retiree Benefits at a Glance   Benefits that Differ for

 Prescription Drugs   Supplemental Medical Plan   Retirees Who Live Outside
 Cap depends on age and/or disability and   This is the only benefit that is available
 your health insurance plan.   solely to retired members. This benefit is
 provided when Medicare or your secondary   of the NYC Metro Area
 Dental Benefits   insurer denies coverage in whole or in part
 Annual Cap/Year of $1250 for each member   for the following
 and eligible family members.   Two Optical Benefits Options    Learn more about
 •   Wheelchair, surgical stockings,
 Eye Exam and Eyeglasses   orthopedic shoes, leg braces, hospital   1.  Reimbursement for services: $45 exam,   Retiree Benefits
 Once every 2 years for each member and   beds, oxygen equipment, blood, private   $105 for materials or $150 allowance for
 eligible family members.   duty nursing (in hospital only) and other   contact lenses out of network.  Retiree FAQs
 durable medical equipment or supplies
 Hearing Aid   2.  General Vision Services, a co-payment
 $1000 once every 5 Years  •   The annual cap is $2500 per family. The   is required for exam and the purchase   Para hablar con un representante en espanol
 benefit is paid at 80% of the reasonable   of frames and lenses. 800-VISION1 or   por favor llame al 866-492-6983
 Death Benefit   and customary charges  general
 $2500 for member only

 Medicare Advantage Plans (Rx Rider)   Dental Benefit
 For Medicare eligible participants who
 elect a health plan such as HIPNIP HMO.    •   $1250 Yearly Max Annual Benefit/Family
 All prescriptions are received with your   Member. (cap)
 health card from the health insurer.   •   5000+ Dentists on the HealthPlex Metro
 (Medicare Advantage Plan)   Panel PPO. (NY Metro area)  Frequently Used

 The Retirees’ Fund provides partial   •   No charge for services listed on the   Retiree Forms
 reimbursement for anyone who chooses this   schedule of benefits, when you use a
 option, payments are;  participating dentist  Change of Address Form

 •   $24 a month for single coverage and    •   HealthPlex National Panel for those who
 $36 a month for family coverage  live outside of the NY Metro area  Retiree Enrollment Form

 •   Checks are sent out twice yearly usually   •   No forms needed. An ID card is provided   Health Benefits Application
 February and August  to eligible participants

 •   Single $144 and Family $216 reflect
 six months of premium reimbursement  Optical Benefit

 •   Once every 2 years a $150 Benefit is
 available to retired members and eligible
 family members
 •   Eligibility and claim forms are now
 obtained from vendors in the CPS
 Optical Network

 Visit the CPS website: or call
 CPS at: 212-675-5745 for vendor locations.

 14     Teamsters Local 237                                                         Member Benefits Brochure     15
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