HOW TO RECEIVE YOUR CO-PAY / CO-INSURANCE REIMBURSEMENT BENEFIT

The Co-payment/CoInsurance reimbursement benefit program is available to all active and retired members and their dependents covered by the Fund, who participate in the Empire Healthy Advantage PPO and EPO Select 20 Plans, provided by the Dutchess Educational Health Insurance Consortium (“DEHIC”).

What is covered?

The Fund will reimburse up to $300 per covered family for any in-network coinsurance and/or co-payment costs incurred under the DEHIC Empire Blue Cross Blue Shield Healthy Advantage PPO and EPO Select 20 Plans.  Once the $300 is reached, the Fund will reimburse 1% of all additional in-network coinsurance and/or co-payment costs incurred during the same period.

When to file a claim?

            Your claim MUST be submitted by 03/31 of the following calendar year for which you’re submitting a reimbursement claim. 

How to file a claim? Download and submit the forms below.

DOWNLOAD:

Co-Pay/Co-Insurance Instructions 

Updated Co-pay/Co-Insurance Form 2024