NON-REIMBURSED

MEDICAL/DENTAL/VISION PLAN

The Non-Reimbursed Medical/Dental/Vision plan will allow members to be reimbursed for otherwise non-reimbursed qualified medical, dental, and vision expenses.

The reimbursement for expenses incurred January 1 through December 31, 2011 is $300 per eligible member.

The reimbursement for expenses incurred January 1 through December 31, 2012 is also $200 per eligible member.

Each member has until March 31 to claim for Non Reimbursed Benefits for the previous calendar year.

The non-reimbursed claim form for the 2011 year can be found here.

The non-reimbursed claim form for the 2012 year can be found here.


What’s covered?

· Prescription co-pays

· Medical visit co-pays

· Upgrades to Vision plan not covered by existing benefits

· Any out-of-pocket medical/dental/vision expenses incurred that are qualified by proper documentation.

Costs incurred by any of the following people may qualify towards the $300.

· The eligible member, his/her spouse, his/her domestic partner* and his/her dependents

You need to complete a claim form, attach your documentation (qualified receipt or Explanation of Benefits) and send it to NEWMAN COMPANY for review and reimbursement.

For example:

Your child goes to the dentist and the cost is $900.00. Your Explanation of Benefits shows that you got less than that amount back from your dental plan, leaving an out-of-pocket patient responsibility. With this benefit, you can now complete a claim form, mail it with your EOB and expect a reimbursement for up to $300.
You’ve just used your Davis Vision Benefit and upgraded your choice of frames or lenses. The out-of-pocket upgrade was $60.00. You can mail your receipt from Davis Vision with the claim form to NEWMAN COMPANY for your $60 reimbursement.
In order to receive this reimbursement, you must fill out a claim form and attach the Explanation of Benefit form (EOB) or qualifying receipt that you received from your insurance company or service provider.

Call the STA office to get these claim forms or click here.

Newman Company will review your claim and documentation. You will a receive reimbursement check up to the maximum amount of $300 per calendar year/per eligible teacher. If you use your spouse’s health plan, you will also qualify for this coverage by submitting your EOB from that plan.

Send completed claims with qualifying EOBs or qualifying receipts to:

NEWMAN COMPANY
925 Hempstead Turnpike
Franklin Square, New York 11010
Tel: (516)488-1100

* Domestic partner status must be on file in the STA office. Please call to complete the proper paperwork.