SEIU Local 200U

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SERVICE EMPLOYEES BENEFIT FUND (SEBF)

OPTICAL BENEFIT

Service Employees Benefit Fund (SEBF) optical benefit reimburses up to $60 per year OR $120 every two years, per person, towards eyecare. If you are enrolled for Family coverage, each eligible family member receives $60 per year or $120 every two years.

THIS BENEFIT COVERS . . .

This benefit may be used towards expenses for routine eye exams, eyeglass frames, eyeglass lenses or contact lenses.

WHO IS INCLUDED IN THE COVERAGE . . .

Individual coverage is for the employee only.

Family coverage includes yourself (the employee), your legal spouse, same sex domestic partner (must meet certain requirements) and your legal dependents. Legal dependents are covered through December 31st of the year they turn age 19; or through December 31st of the year they turn 24 if they are continuous, full-time students.

HOW YOUR VISION BENEFIT WORKS . . .

You may go to any eyecare provider, then submit your itemized bill along with a SEBF optical claim form to:

Service Employees Benefit Fund
P. O. Box 1600
Syracuse, NY 13201

Your claim will be processed and you will be reimbursed appropriately.

EMPIRE VISION CENTERS APPLY BENEFIT PAYMENT IMMEDIATELY, YOU PAY BALANCE

If you go to an Empire Vision Center, present your SEBF or Empire Vision I.D. card. They will call SEBF to verify your eligiblity and your benefit. Then they will apply your benefit to your bill and submit your claim directly to SEBF. Your only responsibility is to pay any amount over the benefit payment.

If you need optical claim forms or if you have any questions regarding the SEBF Optical Benefit, please contact the Fund office at (315) 424-1754 or (800) 733-1754.

CONSUMER TIP
Shop around for sales and the best deal for your benefit dollars!