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February 2019 Published by the F O R Y O U R New York State Nurses Association Benefits Fund Vol. 33 • No. 1 • February 2019 33 • No. Vol. enefit The Fund welcomes the registered nurses of The New York Eye and Ear Infirmary of Mount Sinai (NYEE). NYEE is one of the world’s leading facilities for ophthalmology, otolaryngology, and plastic surgery. 2019 updates to BNew York Paid Effective 1/01/2018 Effective 1/01/2019 NYS Paid Family Leave .126% of .153% of Rate Family Leave covered wages covered wages here are several changes to the New $67,907.84/year or $70,569.72/year or TYork State Paid Family Leave coverage Wage Cap for the 2019 calendar year as we have out- $1,305.92/week $1,357.11/week lined in the chart at right. Participants may Maximum take the maximum benefit length, which Employee $85.56 $107.97 increased to 10 weeks this year, in any given 52-week period. The 52-week period starts Premium Per Year on the first day the participant takes PFL. 50% of statewide 55% of statewide All participants are guaranteed to be able to return to their job after taking PFL. Benefit average weekly wages average weekly wages or $652.91/week or $746.41/week Participants don’t have to take sick leave and/or vacation time before using paid fam- Benefit Duration 8 weeks 10 weeks ily leave. An employer may permit you to use sick or vacation leave for full pay, but may For more information regarding Paid Family Leave, please refer to your Summary Material not require you to use that leave. Please refer Modification, dated 1/2018, and/or the February 2018 For Your Benefits at www.rnbenefits.org to your Collective Bargaining Agreement and/or employer policy regarding use of paid time off. Service Representative. Intermittent and tered through The Hartford on behalf of the emergency absences need to be reported the Benefits Fund. Claims can be made by call- Paid Family Leave was designed to phase same or next business day. ing The Hartford at (800) 549-6514, Monday in over four years, starting January 1, 2018. through Friday, 8 a.m. to 9 p.m. ET. Impor- Any PFL that began in 2018, but continued tant: Participants should identify them- Claims for Paid Family Leave should be into 2019, will be paid based on the number selves as NYSNA Benefits Fund participants filed within 30 days of leave. If not, all or a of weeks/weekly benefit amount for 2018 (as and give the Policy ID #: 020737. portion of the leave may be denied. Denied stated in the above chart) for the length of claims can be appealed, or more informa- the PFL. For more information visit www.ny.gov/ tion, please call the Benefits Fund at (877) new-york-state-paid-family-leave/paid- RN BENEFITS to speak with a Participant Paid Family Leave is insured and adminis- family-leave-information-employees. - FYB Urgent Care or Primary Care? n general, urgent care services someone who knows your health a copay of $75 (Benefit Coverage Ishould be used as supplemental history and can help you manage Plan A) or $100 (Benefit Cover- care to primary care and never as your health long term. For this, age Plan B), while a visit to your a replacement for it. always schedule an appointment primary doctor only requires a $10 with your primary care doctor. copay. Although seeing an urgent care Did you know that choosing If you feel your health situa- provider instead of your primary your primary doctor over an ur- tion is urgent, and it’s after hours care doctor may be more conve- gent care or emergent care pro- for your primary care provider, nient once in a while, it’s not rec- vider can save you money? Urgent it’s a good idea to verify that your ommended on a regular basis. It’s Care facilities are sometimes billed closest urgent care clinic accepts important that you consult with the same as a visit to the ER with UnitedHealthcare/Oxford before you make the trip. - FYB Page 2: Get more vitamin D for healthier winter months Participants are eligible for the shingles vaccine as early as age 50 Page 3: Take advantage of your dental benefits in 2019 Inside: The disadvantages of snacking between meals Page 4: Health Assessments through Oxford Health Get more The Benefits Fund office will be closed on Monday, February 19 vitamin D for Participants are eligible for the for Presidents’ Day and on Friday, March 30 for Good Friday. The healthier shingles vaccine as early as age 50 You may still leave a message for us at (877) RN BENEFITS disadvantages or e-mail [email protected]. of snacking winter months s a Benefits Fund participant you shingles all together. For over a decade, Aare eligible for the shingles vaccina- eligible NYSNA Benefits Fund partici- between meals horter days during the winter tion beginning at age 50. It’s a vaccina- pants have had coverage for the shingles Smeans less hours of sunlight tion worth looking into if you want to vaccine Zostavax. You now have the op- on our faces – and less exposure to avoid the painful symptoms caused by tion to try a newer shingles vaccination, Take advantage of your dental ontrary to popular belief, one of the main sources of vitamin shingles. Shingrix. Shingrix provides earlier pre- Cyour frequency of snack- D for our bodies. Therefore, it’s vention and is more effective in prevent- benefits with the Fund in 2019 ing is far more detrimental than extra important this time of year to Shingles is a viral infection that pro- ing the shingles and its complications. the quality, or lack thereof, of the of the fee schedule. You’re responsible for the get additional vitamin D from your duces a painful rash caused by the snacks you’re consuming. Studies remaining 20 percent. diet. varicella-zoster virus, the same virus Below are answers to some frequently show that one small bag of a salty that causes chickenpox. After you’ve had asked questions about shingles vacci- • Major restorative services, installation of or greasy snack once during the prosthodontics, and orthodontics are paid at Vitamin D is a hormone that chickenpox, the virus lies inactive in nations and your benefits through the day would be better for your teeth nerve tissue near your spinal cord and Benefits Fund: 50 percent of the fee schedule. You pay the than three smaller snacks of fruit plays a critical role in regulat- other 50 percent for these services. brain. Years later, the virus may reacti- like bananas or a treat like raisins. ing the immune system. Though • Orthodontics have a maximum benefit of vate as shingles. When did Fund coverage begin for the vitamin D is naturally present in $1,000 per course of treatment separated by shingles vaccine? The Benefits Fund Fruit, like bananas, and snacks, only a few foods, there are a couple two years. that you can make a regular part of While it isn’t a life-threatening condi- began covering Shingrix through our like raisins, contain concentrated tion, shingles can healthcare service pro- sugars that can aid in plaque your diet during the darker winter Out-of-network option be very painful. vider, UnitedHealth- months: • There’s a $50/individual; $150/family build-up between meals. It’s care/Oxford, effective 1. Fish: The best place to find The first sign of yearly deductible. important to allow time between April 1, 2018. vitamin D is in fatty fish like shingles is often • Diagnostic and preventive care is paid at meals, which gives saliva time salmon, herring, and sardines. burning pain and 80 percent of the usual and prevailing fee, to wash away food particles that sometimes numb- What are the eligi- after the deductible is met. You’re responsi- bacteria would otherwise feast ness or itching, bility requirements ble for the remaining 20 percent and any- on. Frequent snacking, without generally on one for coverage? To be thing over the usual and prevailing fee. brushing immediately afterwards, covered for the previ- side of the body. hrough the Benefits Fund, Aetna ad- • Basic restorative services, endodontics, provides constant fuel to feed bac- After several days, ous shingles vaccine, Tministers dental coverage for you, your periodontics, maintenance of prosthodon- teria, leading to the development a rash of fluid- Zostavax, participants spouse, and your eligible dependents. The tics, and oral surgery are paid at 80 percent of plaque and tooth decay. Try to filled blisters, had to be at least age maximum amount payable for each individu- of the usual and prevailing fee. limit snacks as much as possible, much like chick- 60. This is no longer al for all covered dental expenses incurred • Major restorative services, installation of preferably no more than once enpox, appears the case. The U.S. during a calendar year is $1,200. prosthodontics, and orthodontics are paid a day. Your teeth need a break in one area on Centers for Disease at 50 percent of the usual and prevailing between meals and the plaque one side of the Control and Preven- Two different benefit options are available: fee. build-up they cause. body most com- tion recommend In-network and Out-of-network. You may • Orthodontics have a maximum benefit of monly as a stripe receiving the Shingrix choose either benefit option each time you or $1,000 per course of treatment separated by If snacking is a preferred way to of blisters that vaccination starting at your dependents receive dental services.
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