suffolk county july 2015, volume 42, issue 2 municipal ... · summer 2015 issue & annual report...

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July 2015, Volume 42, Issue 2 Summer 2015 Issue & Annual Report Suffolk County Municipal Employees Benefit Fund Notes Notary Services are available at the Fund. Benefit Fund Office is conveniently located in Suite D at the AME Union building, 30 Orville Dr. Bohemia, NY 11716-2513. 631-319-4099 Inside this Issue: Administrator’s Report 2 New Retiree Eligibility 2-3 Fund and EMHP 4 Legal Residency Rules 5 New Dental Codes 5 NYS Annual Report 6-9 College Verification 10 How to File an Appeal 10 Important Phone Numbers & Websites 11 Trustees & Administration 12 IMPORTANT ITEMS IN THIS ISSUE Administrator’s Report - pg. 2 New Retiree Eligibility - pgs.. 2-3 Entities of Provided Benefits - pg. 4 New Residency Rule for Legal - pg. 5 Updated Dental Codes - pg. 5 Financial Annual Report - pgs. 6-9 SEPTEMBER College Verification - pg. 10 How to File an Appeal - pg. 10 Telephone and Website List - pg.11 LOOK at the FUND’S NEW WEBSITE CREDIT CARD PAYMENTS NOW ACCEPTED “ON-LINE” AT: WWW.SCMEBF.ORG A Joint Labor/ Management Trust Providing ancillary health and legal benefits for our par- ticipants and their families since 1975 July 2015 Page 1

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Page 1: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015, Volume 42, Issue 2

Summer 2015 Issue & Annual Report

Suffolk County

Municipal Employees

Benefit Fund Notes

Notary Services are available at the Fund.

Benefit Fund Office is conveniently located in Suite D at the AME Union building, 30 Orville Dr. Bohemia, NY 11716-2513.

631-319-4099

Inside this Issue:

Administrator’s Report 2

New Retiree Eligibility 2-3

Fund and EMHP 4

Legal Residency Rules 5

New Dental Codes 5

NYS Annual Report 6-9

College Verification 10

How to File an Appeal

10

Important Phone Numbers & Websites

11

Trustees & Administration

12

IMPORTANT ITEMS

IN THIS ISSUE

Administrator’s Report - pg. 2 New Retiree Eligibility - pgs.. 2-3

Entities of Provided Benefits - pg. 4 New Residency Rule for Legal - pg. 5 Updated Dental Codes - pg. 5 Financial Annual Report - pgs. 6-9

SEPTEMBER College Verification - pg. 10 How to File an Appeal - pg. 10 Telephone and Website List - pg.11

LOOK at the FUND’S NEW WEBSITE

CREDIT CARD PAYMENTS NOW ACCEPTED “ON-LINE” AT:

WWW.SCMEBF.ORG

A Joint Labor/

Management

Trust Providing ancillary

health and legal

benefits for our par-

ticipants and their

families since

1975

July 2015 Page 1

Page 2: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015 Page 2

FUND NEWS AND ADMINISTRATOR’S REPORT

Administrator’s Report July 2015

The Board of Trustees made several enhancements to the benefits offered by the Fund recently. First, Retiree Eligibility service years requirements was reduced from twenty (20) years to ten (10) years of service time needed in the Fund for Retiree benefits, retroactive to January 1, 2012, and as seen below and on page 3. Also, Residency Requirements for the Sale or Purchase of a member’s primary residence and an update of all Dental Codes added since 2013(all seen on page 5.) All these changes and more can be seen on the Fund’s new and improved Website! In June, the Fund bid farewell and thank you to Trustees Dan Farrell and Susan La Sala

who both concluded their three (3) year terms, And finally, in July the Fund welcomed new Trustees Daniel C. Levler, who was unanimously appointed to a three (3) year term by the AME Executive Board and to the new AME President, Brian Macri, who fills a term on the Board for the length of his term as Association President. We wish them both congratulations and good luck.

Cheryl A. Felice, Fund Administrator

----------------------------------------------------------------------------------------------------------------------------

NEW RETIREE ELIGIBILITY REQUIREMENTS (DOES NOT AFFECT ANYONE CURRENTLY RECEIVING RETIREE BENEFITS FROM THE FUND)

Adopted June 4, 2015, Retroactive to and Effective January 1, 2012: SCMEBF Retiree Eligibility

1. When you retire, you must meet the following eligibility requirements in order for your coverage to continue:

Be at least age fifty-five (55); and

Have ten (10) cumulative years of service as a full time Suffolk County employee or a contributing agency of the

Fund, of which no fewer than five (5) years* of continuous service time must be contiguous to the date of retire-

ment within the applicable retirement system; or have been granted an EMHP Waiver and have ten (10) years of

credited service in the appropriate NYS public employees for contributing agency retirement system; and be eli-

gible to retire under the Tier in which you are registered; or

Or be covered under one of the special plans whereby you are eligible for retirement benefits regardless of age

after completion of a specified number of years (i.e., twenty (20) or twenty-five (25) years)*.

*You must also have a minimum of ten (10) cumulative years of service as a full time employee of Suffolk County or a

contributing agency, of which no fewer than five (5) years of continuous service time must be contiguous to date of re-

tirement within the applicable retirement system, is required. Except for School Crossing Guards, if the service was in a

less than full-time position, the employee’s service time will be prorated based on the numbers of hours worked per week

to a comparable full time equivalent position. These service requirements will be waived in the event of a disability re-

tirement as defined below in paragraph 2.

*If age 70 at retirement, service requirement is reduced to five (5) years, however service time with Suffolk County or a

contributing agency remains as ten (10) cumulative years of service of which no fewer than five (5) years of continuous

service time must be contiguous to date of retirement.

2. Disability Retirement

If the employee has been approved by the retirement system or social security for a disability retirement, the em-

ployee and eligible dependents are eligible for Fund coverage regardless of age or service time, as a Fund retiree. To be

certain of remaining eligible for Fund coverage, the employee must continue his/her Fund coverage with timely premium

payments while he/she waits for the decision on the disability retirement.

If the employee does not continue coverage or if he/she fails to make the required payments while awaiting the

disability retirement determination, coverage for the former employee and his/her dependents will end. Coverage may

end permanently.

(con’t on page 3)

Page 3: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

FUND TRUSTEE TERMS CONCLUDE & NEW RETIREE ELIGIBILITY

July 2015 Page 3

(con’t from page 2) NEW RETIREE ELIGIBILITY REQUIREMENTS

If the disability retirement is not granted, then Fund benefits are not available and/or will be terminated. The for-

mer employee will not be eligible to re-enroll in the Fund.

If the disability retirement is granted, then continued coverage under the Fund is dependent upon two things:

Whether or not the former employee made the required payments to maintain Fund coverage upon termination of

employment (e.g., continued paying COBRA self-pay premiums and/or post-COBRA period self-pay premiums); and for

retiree benefits by the Fund, these premiums will be refunded to the former employee. However, if the former employee did

not continue his/her Fund coverage by making the required interim, Post-COBRA self-pay premium payments, then to con-

tinue coverage as a retiree, all retroactive premiums must be paid in full. Coverage will be effective the first day of the

month following receipt by the Fund of the disability retirement decision, all retroactive self-pay premiums and all complet-

ed documents required for enrollment, subject to the effective date of disability retirement being a date on which the former

employee was not otherwise terminated from employment.

Members must apply in writing within thirty (30) days of the date of the written decision from the retirement system,

requesting reinstatement of Fund coverage. In such a case, if reinstatement is granted, coverage will be effective on the first

day of the month following the receipt by the Fund of the disability retirement determination, all retroactive self-pay premi-

ums, if applicable, and all completed documents required for enrollment.

3. Continuing Coverage for Vested Participants

Eligibility for Coverage as a Vested Participant upon Separation from Employment, then the following rules for

Continuing Coverage for Vested Participants will apply:

Employees who meet all of the eligibility criteria set forth above for the continuation for benefits into retirement,

other than age, but who are within 5 years of retirement age (55), will be notified that they may continue their Benefit Fund

coverage as a vested participant by continuously paying premiums. The vested participant must directly pay the self -pay

“premium” to the Fund for continued coverage. Third party checks/payment will not be accepted. If the vested participant

continuously pays premiums until age fifty-five (55), the Fund would then cover him/her as a retiree; if premiums are not

paid at any time during this interim period, coverage cannot be reinstated. A vested participant who has family coverage may

change to individual coverage during this period, but may not reinstate family coverage at any time thereafter.

(replaces entire section entitled “Who is eligible” in the Benefit Reference Guide, 2008 on page 16)

Fund Vice Chairman Dan Farrell, pictured left, served as a Trustee for ten (10) years and Susan

La Sala, (right) was a Trustee for the last three (3) years. The Fund wishes them well as both terms con-

cluded on June 30, 2015.

Page 4: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015 Page 4

THE DIFFERENCE BETWEEN THE SC Municipal Employees BENEFIT FUND & EMHP

The SCME Benefit Fund is a private entity, separate from Suffolk County Government and administered through a joint Labor/Management Trust.

Ancillary Benefits for:

Active & Retired* Members, COBRA, & All “Self-Pay” Enhanced Retiree Plans Dental (Full coverage for Active, COBRA, and “Self-Pay” Enhanced Retirees. *Limited Retiree coverage for “No-Cost” Basic Retirees at $750 family/$500 individual)

Hearing Aid (For out-of-pocket expenses, per eligible dependent, up to $400 once every 36 months, voucher required)

Optical (For up to $80/once per calendar year, per eligible dependent, voucher required)

Active, COBRA & “Self-Pay” Enhanced Retiree Premium Plus & Platinum Plans

Prescription Co-Pay Reimbursement *(not available to “No-Cost” Basic Retirees) (Up to $20 per script up to $350, PLUS $1 additional for each eligible script over $350/per family, once per calendar year. Rx claim form and print-out of prescriptions required. Reimbursed in date-filled order.)

Active, "Self-Pay” Enhanced Retirees, Platinum Plan

Legal Reimbursement *(not available to “No-Cost” Basic Retirees) (Voucher required specific to the type of legal services requested, up to $1000 per family, once per calendar year in accordance with the Legal Plan fee schedule, eligibility and limitations)

Tax Preparation *(not available to “No-Cost” Basic Retirees) (Voucher required, per family, up to $70/1040 Form or up to $30/1040A Form, once per calendar year)

Active Members ONLY *(Bereavement/Survivors Benefits ENDS at retirement or active employment) Bereavement Benefit ($10,000 for Active Member ONLY)

Survivors Benefit ($1,000 for Active Member, Spouse, enrolled Domestic Partner )

Other Participating Unions in the SCME Benefit Fund , include:

SC Corrections Officers Assoc., SC Deputy Sheriff’s PBA, and the SC Probation Officers Assoc.

~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

**THE COUNTY HEALTH PLAN IS NOT ADMINISTERED BY THE SCME BENEFIT FUND

If you need information on your health plan, please contact ** SC Employee Medical Health Plan (EMHP)

Employer-Sponsored Health Benefits are Administered

by the Suffolk County EMHP and the Employee Benefits Unit (EBU) for:

1) Doctors/Hospitals 2) Prescription Drugs

3) Mental Health 4) Blood/Lab Work

Email: [email protected]

or call (631) 853-4866

Page 5: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015 Page 5

NEW DENTAL PROCEDURE CODES ADDED SINCE JULY 2013

ADA Code Description GP Fee Specialist

Fee

Frequency Date Added UCR* Remarks

0180 Perio-evaluation

Comprehensive

$25 $35 1/calendar yr. 1/1/13 No from perio max

0273 3 Bitewing

x-rays

$18 $18 2/12 months 1/1/14 No from general max

0277 7-8 Bitewing

x-rays

$35 $35 2/12 months 1/1/14 No from general max

4249 Crown

Lengthening

$325 $325 1/L per tooth 2/5/15 No from perio max

4265 Emdogain $0 $400 1/4 years 1/1/14 Yes from perio max

4277 Free soft tissue

graft procedure

$150 $190 1/4 years 1/1/14 No from perio max

4278 Free soft tissue

graft; addt'l. teeth

$100 $140 1/4 years 1/1/14 No from perio max

6053 Implant

Supported Full

Denture

$650 $650 1/60 mos. 1/1/13 Yes from general max

6054 Implant

Supported

Removable

Partial Denture

$695 $695 1/60 mos. 1/1/13 Yes from general max

6080 Implant

Maintenance

$0 $75 1/6 mos. per

quad; 1-8 teeth

6/1/15 Yes from perio max

6090 Implant Repair $0 $150 1/3 years 6/1/15 Yes from general max

6104 Bone Graft at

time of Implant

$0 $225 1/L per tooth 1/1/14 Yes from general max

7260 Oroantral Fistula

Closure

$0 $395 none 2/1/13 Yes from general max

7261 Primary Closure

of a sinus

perforation

$0 $375

if clinically

approved by

Admin Dec.

1/1/13 Yes from general max

UPDATES TO THE BENEFIT REFERENCE GUIDE AND DENTAL PROCEDURE CODES

As you have been made aware of over the years, via newsletter and general correspondence, the Board

of Trustees of the SCME Benefit Fund have instituted several enhancements to your Benefit Fund coverage

since its last printed publication of the January 2008 Benefit Reference Guide (“booklet”) and Legal Reference

Guide. The following is a summary of those “ENHANCEMENTS” to your benefit coverage. All other terms

and conditions set forth in the January 2008 BRG & LRG, remains ineffect and applicable.

LEGAL SERVICES BENEFITS

Adopted June 4, 2015, Retroactive to and Effective 1/1/2015: New Legal Language for Home Sale/Purchase.

Covered members must reside in Suffolk County in order to be eligible for legal services plan benefits, unless

the following occurs: you are an out of area retiree who enrolled in and paid for the Platinum Plan; you were

hired pursuant to a waiver or for a position that is excepted from the Suffolk County Charter, Article VI, sec-

tion C6-3.

NEW DENTAL PROCEDURES ADDED AND NEW ALLOWANCES FOR HOME/SALE PURCHASE RESIDENCY

*UCR- In-Network Providers may charge additional Usual and Customary Rates on certain procedures.

Page 6: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

Fund Files NYS Insurance Department Annual Report The 2014 Annual Report for the Suffolk County

Municipal Employees Benefit Fund is shown on pages, 7-9.

Each year the Fund is subject to periodic exami-nation by the New York State Department of Financial Services (NYS-DFS). Requirements of the periodic examination are listed in Section 312 of the NYS Insurance Law. The Fund is required to distribute the periodic examination to the plan participants. A copy of this report is enclosed for your review. This re-port shows the financial condition of the Fund, known as the Annual Report.

Year after year, the report revels the excellent financial health of the Fund and exemplary services delivered by the Trustees and staff members on behalf of all Fund participants.

On behalf of all of us here at the Fund, thank you for allowing us to provide these benefits and services to you. If you need any further infor-mation, please call the Fund Administrator at 319-4099, extension #319. We are happy to answer any questions you may have about the Fund or the 2014 Annual Report. Thank you.

Cheryl A. Felice, Fund Administrator

FUND FILES 2014 NYS-DFS ANNUAL REPORT

July 1st the Fund Welcomed New Association Trustees

Brian Macri, AME President and

Daniel C. Levler, AME Executive Vice President

July 2015 Page 6

Page 7: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015 Page 7

FUND FILES 2014 NYS-DFS ANNUAL REPORT

ANNUAL REPORTS

For the fiscal year ended December 31, 2014

SUFFOLK COUNTY MUNICIPAL EMPLOYEES BENEFIT FUND

30 ORVILLE DRIVE, SUITE D, BOHEMIA, NEW YORK 11716

to the SUPERINTENDENT OF INSURANCE of the STATE OF NEW YORK

- BENEFIT FUND -

STATEMENT OF CHANGES IN FUND, BALANCE (reserve for future benefits)

ADDITIONS TO FUND BALANCE

Contributions:

(a) Employer $11,341,532

(b) Employee 238,048

(c) Other (Specify) Retired Members 799,522

(d) Total Contributions $ 12,379,102

Dividends and Experience Rating Refunds from Insurance Companies

Investment Income:

(a) Interest 315,708

(b) Dividends 145,748

(c) Rents

(d) Other (Specify)

(e) Total Income from Investments 461,456

Profit on disposal of investments 993,027

Increase by adjustment in asset values of investments

Other Additions: (itemize)

(a) See Statement of Changes in Fund Balances (Reserve for Future Benefits) 1,591,585

(c) Total Other Additions 1,591,585

Total Additions $ 15,425,170 DEDUCTIONS FROM FUND BALANCE

Insurance and Annuity Premiums to Insurance Carriers and to Service Organizations (Including Prepaid Medical Plans)

Benefits Provided Directly by the Trust or Separately Maintained Fund $ 10,660,140

Payments to an Organization Maintained by the Plan for the Purpose of Providing Benefits to Participants

Payments or Contract Fees Paid to Independent Organizations or Individuals providing Plan Benefits (Clinics, Hospitals, Doctors, etc.)

Administrative Expenses:

(a) Salaries 594,802

(b) Allowances Expenses, etc. 11,417

(c) Taxes 45,051

(d) Fees and Commissions 675,328

(e) Rent 104,399

(f) Insurance Premiums 174,665

(g) Fidelity Bond Premiums 430

(h) Other Administrative Expenses: (Specify) See Statement of Changes in Fund Balances (Reserve for Future Benefits)

559,727

(i) Total Administrative Expenses 2,165,819

Loss on disposal of Investments 125,967

Decrease by adjustment in asset values of investments 90,301

Other Deductions: (itemize)

(a) See Statement of Changes in Fund Balances (Reserve for Future Benefits) 11,670,586

(b) Contributions allocated to SCME Legal Services Fund

(c) Total Other Deductions 11,670,586

Total Deductions $ 24,712,813

RECONCILEMENT OF FUND BALANCE

Fund Balance (Reserve for Future Benefits) at Beginning of year $(15,321,858) Total Additions During Year 15,425,170

Total Deductions During Year (24,712,813)

Total Net Increase (Decrease) (9,287,643) Fund Balance (Reserve for Future Benefits) at End of year (Item 14, Statement of assets and Liabilities)

$ (24,609,501)

Page 8: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015 Page 8

FUND FILES 2014 NYS-DFS ANNUAL REPORT

- BENEFIT FUND -

STATEMENT OF ASSETS AND LIABILITIES

ASSETS

End of Reporting Year Cash 2,795,465

Receivables

(a) Contributions:

(1) Employer 50,481

(2) Other

(b) Dividends or Experience Rating Refunds

(c) Other (Specify): Due from Staff Retirement Plan

Investments (Other than Real Estate)

(a) Bank Deposits At Interest and Deposits or Shares In Savings and Loan Associations 592,375

(b) Stocks:

(1) Preferred

(2) Common 9,019,027

(c) Bonds and Debentures:

(1) Government Obligation

(a) Federal 11,248,097

(b) State and Municipal

(2) Foreign Government Obligations

(3) Non-Government Obligations 2,865,404

(d) Common Trusts

(e) Subsidiary Organizations

Real Estate Loans and Mortgages

Loans and Notes Receivable: (Other than Real Estate)

(a) Secured

Real Estate:

(a) Operated

(b) Other Real Estate

Other Assets:

(a) Accrued Income 79,183

(b) Prepaid Expenses 7,341

(c) See Statement of Assets & Liabilities 407,061

Total Assets $27,064,434

LIABILITIES Insurance and Annuity Premiums Payable

Unpaid Claims (Not Covered by Insurance)

Accounts Payable 76,445

Other Liabilities - See Statement of Assets & Liabilities 51,597,490

Reserve for Future Benefits (Fund Balance) (24,609,501)

Total Liabilities and Reserves $ 27,064,434

ADDITIONAL INFORMATION IS AVAILABLE

REPORT ON EXAMINATION: This fund is subject to periodic examination by the Department of Financial Services. All employee-members of the fund, all contributing employers and the participating unions may inspect the Reports on Examination at the New York State Insurance Department, upon presentation of proper credentials. If you wish to see the Report, please contact the New York State Department of Financial Services, Life Insurance Companies Bureau, 25 Beaver Street, New York, NY 10004 - Telephone (212) 480-5038

Page 9: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

July 2015 Page 9

FUND FILES 2014 NYS-DFS ANNUAL REPORT

SUFFOLK COUNTY MUNICIPAL EMPLOYEES BENEFIT FUND

Attachment to Annual Report - December 31, 2014

Statement of Changes in Fund Balance (Reserve for Future Benefits) Other Additions: Post-Retirement: Benefits paid (Estimated)_ Obligations for current benefit coverage: Benefit claims incurred but not reported

1,500,000 91,585

Total Other Additions $ 1,591,585 Statement of Changes in Fund Balance (Reserve for Future Benefits) Other Administrative expenses: Pension expense 294,968 Computer 55,062

Stationery, printing and office expense 75,091 Postage 23,172 Depreciation and Amortization 32,272

Members’ benefit information 54,526 Telephone 8,580 Bank Charges 3,806 Dues and Subscriptions 4,914

Meeting Expense 7,336 Miscellaneous expense Total Administrative expenses: 559,727

Statement of Changes in Fund Balance (Reserve for Future Benefits)

Other Deductions:

Provision for sick and vacation 22,071 Claims Payable 55,585 Post Retirement: Benefits earned and other charges 8,906.000 Interest 1,701,000 Pension adjustment other than net periodic pension cost 985,930

Total other Deductions: 11,670,586

Statement of Assets and Liabilities Other Assets: Leasehold Improvements 436,152 Furniture and Fixtures 67,105 Computer Equipment 259,087 Subtotal 762,344 Less: Accumulated Depreciation and Amortization (369,708) Net: 392,636 Security Deposit 14,425

Total Other Assets: 407,061 Statement of Assets and Liabilities Other Liabilities: Prepaid Retiree Contributions 437,440 Pension Liability 2,254,826 Employees accumulated vacation and sick pay 66,224 Claims Payable 736,433 Estimated Liability for claims incurred but not reported 1,575,567 Estimated Liability for future payments of benefits based on participants’ accum. Eligibility 1,000 Post retirement benefits for current retirees 21,315,000

Post retirement benefits for other participants fully eligible for benefits 11,510,000 Post retirement benefits for other participants not fully eligible for benefits 13,701,000 Total other Liabilities: 51,597,490

Page 10: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

ELIGIBILITY CORNER, NEWS & NOTES

July 2015 Page 10

SCME BENEFIT FUND - RIGHT TO APPEAL

The benefits provided by this Fund may be changed by

the Board of Trustees at any time, in their sole and abso-lute discretion. The Board of Trustees adopts rules and regulations for the payment of benefits. All provisions of

the Benefit Reference Guide (BRG) are subject to such rules and regulations and to the Trust Agreement, which

established and governs the Fund operations. All benefit and eligibility rules are uniformly applied by the Fund of-

fice and Third-Party Administrators. The actions of the Fund or its Administrators are subject to review by the

Board of Trustees.

A member or beneficiary may request an APPEAL of

any action by submitting a written request to the Board of

Trustees within 180 days of the last determination:

Suffolk County Municipal Employees Benefit Fund

Attn: Board of Trustees, for Appeal

30 Orville Drive, Suite D

Bohemia, New York 11716-2513

The Trustees shall act on the appeal within a reasonable period

of time and render their conclusive decision in writing, which shall be final and binding on all persons.

Keep Enrollment Information Up-To-Date!

Fax or mail all changes in addresses, phone numbers and dependents,

changes in marital status, (include the divorce decree) to:

SCME Benefit Fund

“Attention: Eligibility” our FAX line is private & confidential

631-218-7970 If mailed, send to:

30 Orville Dr., Suite D, Bohemia, NY 11716-2513 ~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~~

Updated Beneficiary Forms should be sent to your

Employer/Department or Payroll/Personnel/Human Resource Division

Availability of HIPAA

Notice of Privacy Practices (as of 9/23/13)

The Suffolk County Municipal Employees Benefit Fund adheres to the

HIPAA Notice of Privacy Practices ("Privacy Notice"), describing how health information of individuals covered by the Fund may be

used and disclosed. See the Fund’s website and instructions on how

you may obtain a copy of the Privacy Notice, which may also be downloaded from the Fund’s website at: www.scmebf.org

For a printed copy of the

Fund’s Privacy Notice, please write to :

Cheryl A. Felice, Privacy Officer

Suffolk County Municipal Employees Benefit Fund

30 Orville Drive, Suite D,

Bohemia, New York 11716-2513

631-319-4099, ext 319

REMEMBER September

College Verification

In an effort to simplify College Veri-

fication requirements for your depend-

ents ages 19 to 25, the SCME Benefit

Fund made the following modifications

to coverage verification between semes-

ters.

College verification for the Spring

Semester coverage will be from Janu-

ary 1st through September 30

th, elimi-

nating the need for temporary verifica-

tion to cover your dependents over the

summer months.

College verification for the Fall Se-

mester will now provide coverage from

September 1st through January 31st,

eliminating the need for temporary veri-

fication to cover your dependents

through the next semester in January.

Should you have any questions or

concerns, please contact:

Eligibility Coordinator

631-319-4099 ext. 321

Page 11: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

Quick Reference Guide of Phone Numbers & Websites

BENEFIT FUND

SC Municipal Employees Benefit Fund SCMEBF fax number Fund Email Contact

Fund Administrator Emergency/Urgent Voice Mail

www.scmebf.org [email protected] (list type of inquiry in the memo line)

[email protected]

1-631-319-4099 1-631-218-7970

1-631-319-4099 Ext. #319

DENTAL - 3rd-Party Administrator Healthplex, Inc. (Customer Service) Healthplex Email Contact Benefits and Dental Claims Supervisor at the Benefit Fund

www.healthplex.com [email protected] [email protected] (list type of inquiry in the memo line)

1-888-468-5178 1-631-319-4099 Ext. #0

EMHP (Health Benefits) Enrollment and Eligibility Employee Benefit Unit Email & Phone

Employee Medical Health Plan www.emhp.org [email protected]

1-631-853-4866

DOCTOR/HOSPITAL Empire Blue Cross Blue Shield 24-Hour Nurse Talk Line Out-of-State Network Providers

www.empireblue.com/emhp www.bcbs.com

1-800-939-7515 1-877-Talk2RN 1-800-810-BLUE

PRESCRIPTION BENEFITS Express Scripts (for Medicare Retirees) Prescription Waiver Forms WellDyneRx (ID# on Card begins after “SC”)

www.express-scripts.com Handled with your doctor and WellDyneRx

emhp.welldynerx.com

1-800-950-2662 1-855-799-6831

MENTAL HEALTH BENEFITS Value Options (Mental Health)

www.valueoptions.com

1-866-909-6472

LAB WORK Contact: Empire Blue Cross Blue Shield

www.empireblue.com/emhp

1-800-939-7515

PARTICPATING UNIONS SC Association of Municipal Employees

(Suffolk County Community College and Westhampton Village Highway)

SC Probation Officer’s Association SC Deputy Sheriff ’s PBA SC Correction Officer’s Association

www.scame.org www.scpoa.org www.scdspba.net www.sccoa.net

1-631-589-8400 1-631-654-2080 1-631-289-1768 1-631-208-1301

NYS RETIREMENT SYSTEM www.osc.state.ny.us/retire/ 1-518-474-7736

July 2015 Page 11

Ancillary coverage from the Benefit Fund,

SCMEBF is separate from your Employer-Sponsored

Health Plan, EMHP.

Inquiries about your Health

Plan for:

Prescriptions Claims WellDyneRx

I.D. Cards Blue Cross Lab Work

Behavioral Health should be directed to: Employee Benefits

Unit at 631-853-4866

or email to: [email protected]

For Prescription information call:

WellDyneRx 1-855-799-6831 For Emergency Issues Anytime, call 631-319-4099, ext. #319

Page 12: Suffolk County July 2015, Volume 42, Issue 2 Municipal ... · Summer 2015 Issue & Annual Report Suffolk County Municipal Employees . Benefit Fund Notes Notary Services are available

PRESORTED FIRST CLASS

U.S. POSTAGE PAID CENTEREACH, NY

PERMIT NO. 5

BOARD OF TRUSTEES

TRUSTEES JEFFREY L. TEMPERA

Chairperson ~

DENNIS M. BROWN JENNIFER K. MCNAMARA

FRANK NARDELLI

TRUSTEES BRIAN MACRI

Vice Chairperson ~

DANIEL C. LEVLER MICHAEL J. FINLAND

CONI LORENZEN

CHERYL A. FELICE, FUND ADMINISTRATOR Emergency Voice Mail 631-319-4099 ext. 319

PHONE (631) 319-4099 FAX (631) 218-7970 www.scmebf.org

Email Inquiry Address - [email protected]

To the extent that this newsletter describes any benefit provided by this Fund, which is already described in the Fund’s comprehensive Benefits

Reference Guide, or as amended in subsequent writings issued by the Fund, or a policy of insurance (e.g., life insurance), the language of the Benefits

Reference Guide, as amended, and/or the group insurance contract, which specify the exact benefits provided, will govern in the event of

inconsistency between it and the language of this newsletter.

30 Orville Drive, Suite D Bohemia, New York 11716-2513

Suffolk County Municipal Employees Benefit Fund Joint Labor - Management Trust