Administered by Administrative Services Only, Inc. (800.537.1238)

Up to $200 reimbursement for ambulance use after primary carrier reimbursement.

Up to $500 reimbursement for emergency room services after primary carrier reimbursement. Claims are limited to 5 per family, per calendar year. The benefit is paid for members, spouse, and eligible dependent children.

Administered by Administrative Services Only, Inc. (800.537.1238)

Up to $500 reimbursement for in-hospital anesthesia after primary carrier reimbursement. EOB from your primary care provider must be submitted with claim form. The benefit is paid for member, spouse, or dependent child. Once per calendar year per individual.

Administered by Administrative Services Only, Inc. (800.537.1238)

If you are a GHI subscriber and you, your spouse or an eligible dependent child incur catastrophic medical expenses which results in out-of-pocket expenses in excess of $2,000, GHI will pay 100% of the usual and customary charges of the current profile if you have purchased their expanded plan. 

EXPENSES SUBMITTED MUST QUALIFY UNDER GHI AS "COVERED EXPENSES."

 Lifetime maximum per individual is $250,000.

Administered by Sele-Dent (800.520.3368)

$50 annual deductible for all eligible participants, including dependents

$200 copay on placement of implant

$200 copay on any adult orthodontics commencing after age 26 for member or dependents

$50 copay on all crowns, bridges, and dentures

$3,500 Individual Calendar Year Maximum 

$3,500 Lifetime Orthodontic Maximum 

For dental providers and/or plan details call Sele-Dent or log on to their website at www.Sele-Dent.com

Administered by Administrative Services Only, Inc. (800.537.1238)

The Fund will pay a maximum of $200 per calendar year to reimburse some of your health care out-of-pocket expenses. You may receive reimbursement for medical, dental, hospital, (non-Medicare Part D) prescription, and optical co­payments or deductibles. Benefits will not be payable for expenses that do not meet the IRS guidelines.

Administered by General Hearing Services (GHS) (888.899.1447)

The Fund will pay up to a maximum total of $1,000 once every three years. You may use an in-network or out-of-network provider. All out-of-network claims should be mailed to Administrative Services Only, Inc. For in-network provider locations or specific benefit information, please contact General Hearing Services. The benefit is for members, spouses, and eligible dependents.

Administered by Administrative Services Only, Inc. (800.537.1238)

$100 per day. 

Maximum of 4 consecutive days. 

No coverage first day. 

Member only benefit. 

One claim per calendar year.

Administered by Inner Imaging (212.747.8900)

Provides a full-body scanning to detect diseases of the heart, lungs, etc., in the early stages. All active members will receive a $200 benefit payment toward any of the tests specified below. This $200 benefit is limited to one every five years. The tests must be done at an Inner Imaging facility:

165 E 84th Street

New York, NY 10028

This benefit is limited to members only. Spouses and dependents can utilize the Inner Imaging facility at discounted rates, but there is no benefit payable from the Correction Captains Association.

Advanced screening tests include:

• Heart Scan
• Lung Scan
• Full Body Scan
• Virtual Colonography
• Non-Invasive EB Angiography
• Nuclear Stress Testing

Administered by Amalgamated Life (646.522.0370)

$150,000 Employee (Plus $1,000 from Union)

$20,000 Spouse 

$4,000 Dependent Children (Plus $2,000 from Union)

$50,000 AD&D (Member Only. See benefit booklet for details)

Administered by Administrative Services Only, Inc. (800.537.1238)

$1,500 for each live birth when proof of claim is submitted. A birth certificate is required that indicates that the member is the biological parent. No benefit for adoptions.

NOTE: In order for maternity benefit to be paid, member must enroll the newborn child by filling out this form and submitting a birth certificate.

Administered by Administrative Services Only, Inc. (800.537.1238)

Fund will reimburse 50% of cost up to $250 once per calendar year per member and eligible dependent for medically prescribed appliances which are not covered under medical plan. Proof of submission to medical carrier required. The benefit is paid for member, spouse, and eligible dependents.

Administered by 

General Vision Services (800.847.4661) 

Comprehensive Professional Services (CPS) (212.675.5745)

Provides an eye examination and one pair of prescription eyewear, per calendar year per member and eligible dependents. Check for list of current participating providers by visiting either the GVS website or CPS website.

For out-of-network eye exam and prescription eyewear, reimbursement is up to $115 per calendar year for eyeglasses, bifocals, or contact lenses and eye exam.

Administered by Administrative Services Only, Inc. (800.537.1238)

For children up to 5 years of age. 50% of total cost, less 20%. 

$500 maximum per year for first two years. 

$600 lifetime maximum per family. (Offered only when not covered under medical program.)

Administered by Express Scripts (Group #J32A) (800.451.6245)

Plastic Card Program. Mandatory generic dispensing.

Generic drugs: Member pays the greater of $5 or 15%.

Brand name when no generic equivalent: Member pays the greater of $10 or 20%.

Brand name with generic equivalent: Member pays greater of $5 or 15% of the cost of generic plus the difference in the cost between the generic and the brand name.

Quantity limitations: As prescribed, up to and include a 34-day supply or 100 units, whichever is greater.

Mandatory mail order for maintenance drugs.

Direct-mail order is mandatory after the second purchase at a retail pharmacy. After your second purchase at a retail pharmacy, you will pay the entire cost of the maintenance medication if you have not signed up for home delivery.

There is a no yearly cap per family for Plastic Drug Card and maintenance drug program.