February 2019

in over four years, starting January 1,2018. time off. and/or employer policy regarding of use paid to your Collective Bargaining Agreement not require you to that use leave. Please refer sick or vacation leave for full pay, but may ily leave. and/or vacation before time using paid fam return to jobafter their taking PFL. participantsAll are guaranteed able to be to on first the day participantthe takes PFL. starts Theperiod 52-week52-week period. increased to 10weeks year, this inany given maximum the take benefitwhich length, chart inthe lined at right. Participants may for 2019calendar the year as we have out T RN BENEFITS to speak with aParticipant toRN BENEFITS speak Benefits the tion, call Fund please at (877) claims appealed, can be or more informa portion of leave the may denied. Denied be within days 30 filed of leave. If not, all or a Paid Family Leave to was designed phase Participants don’t have to sick take leave I The Fundwelcomes thenurses of Theregistered New YorkEye and Ear ofInfirmary Mount Sinai (NYEE). 2019 updates to Claims for Paid Family Leave should be Vol. 33 • No. 1 • February 2019 York State Paid Family Leave coverage here are changes several to New the Nurses Association Family Leave NYEE is one ofNYEE is the world’s leading facilities for ophthalmology, otolaryngology, and surgery. plastic nside: Published byPublished the New York State Benefits Fund An employer may permit you to use NYS Paid

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Page 4: Page 3: Page 2: - nient once it’s inawhile, not rec care doctor may more be conve provider instead of your primary a replacement for it. care tocare primary as and never I important that you consult with ommended on aregular basis. It’s - Although an seeing urgent care - should be used as supplemental as should beused n general, urgent care services Health Assessments through Oxford Health The disadvantages meals between of snacking Take advantage of your dental benefits in2019 Participants are for eligible asage50 asearly vaccine theshingles moreGet vita Modification,dated 1/2018, and/or the 2018 February For www.rnbenefits.org YourBenefits at enefit For more information regarding Paid Family to your refer Summary Leave, please Material stated above inthe chart) for length the of of weeks/weekly benefit amount for 2018(as oninto number paid the based be 2019,will same or next business day. emergency reported to absences the need be Representative.Service Intermittent and the PFL.the Premium PerPremium Year Any PFL that began in2018,but continued Paid Family Leave is insured and adminis Benefit Duration Benefit New YorkPaid Urgent Care? Care or Primary Family Leave F ORYU Maximum Maximum Wage Cap Employee Employee Benefit Rate min Dfor winter healthier months - - the samethe as avisit to ERwith the Care facilities are sometimes billed canvider save you money? Urgent gent care or emergent care pro your doctor over primary an ur with your care primary doctor. always schedule an appointment your long health term.For this, andhistory can help you manage someone knows who your health Did you know that choosing Effective 1/01/2018 Effective average weekly wages $67,907.84/year or or $652.91/week $1,305.92/week 50% of statewide covered wages .126% of 8 weeks $85.56 - family-leave-information-employees. new-york-state-paid-family-leave/paid- and the give Policy ID#:020737. selves NYSNA as Benefits Fund participants tant: Participants them should identify through Friday, 8a.m.to 9p.m. ET. ing The Hartford at (800)549-6514, Monday Benefits Fund.Claims canbe made call by tered through The Hartford behalf theon of For more information visit - - you make trip. the UnitedHealthcare/Oxford before closest urgent care clinic accepts it’s that to idea verify your agood for your care primary provider, tion is urgent, and it’s after hours copay. doctor onlyprimary requires a$10 age avisit Plan B),while to your PlanCover A)or $100(Benefit a copayCoverage of $75(Benefit

If you feel your situa health Effective 1/01/2019 average weekly wages $70,569.72/year or $1,357.11/week 55% of statewide 55% of statewide or $746.41/week covered wages 10 weeks .153% of $107.97 - FYB www.ny.gov/

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- FYB - - - - 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. two years. keep yourself going throughout wraps around one age 50. the day, choose snacks like cheese, 2. Fortified foods: Many cold side of your torso. The in-network option requires you to seek Advance claim review especially an aged cheese like cereals are now fortified with Sometimes the If I’ve already re- care from a provider in the Aetna Preferred When charges for an anticipated dental ser- cheddar or Swiss. These foods help vitamin D. You can also find rash occurs around one eye or on one ceived the Zostavax vaccine am I still Provider Organization (PPO) network. If vice or series of dental services are expected to to trigger the flow of saliva, which the nutrient added to certain side of the neck or face. covered for Shingrix? you already have a relationship with a dentist be $350 or more, you may receive an advance wash food particles away from the claim review from Aetna to determine the brands of orange juice and Yes. Under the guidance of your doc- who doesn’t belong to this network, or leaves teeth. benefits the plan will pay for the proposed ser- yogurt in any grocery store. A person with a shingles rash can pass tor, participants should opt for Shingrix the network, you’ll still be able to receive care vices. Your dentist should submit a claim form 3. Eggs: Eggs are a great source of the virus to someone, usually a child, over Zostavax and get Shingrix even if from that provider. However, you’ll need to When you snack during the day for an advance claim review (previously vitamin D, with two large eggs who has never had chickenpox, but that you’ve already received the Zostavax use the out-of-network benefit option, which on high carbohydrate treats, brush known as a predetermination of benefits) to providing about one-tenth of a person will develop chickenpox, not vaccination. allows you to see any nonparticipating den- or rinse your mouth with water Aetna showing the treatment plan and fees. daily dose of vitamin D. shingles. A person with chickenpox can tist. You can choose either benefit option any soon afterward, if possible. - FYB give someone else chickenpox but can- When can I get the Shingrix vacci- time you or your dependents receive services. Aetna may request supporting X-rays and 4. Milk: In addition to containing other diagnostic records. Aetna will then plenty of bone-strengthening not pass on shingles. nation? The CDC’s approved dosage for healthy adults is two doses of the Network providers and benefits determine the benefits payable for each dental calcium, most commercially service according to the terms of the Fund’s Treating shingles Shingrix vaccine administered two to The network option allows you to see a pro- produced pasteurized milk in dental plan and will notify you and your Early and immediate treatment can six months apart. Consult your physi- vider in the Aetna Preferred Provider the U.S. is fortified with at least dentist of the estimated benefits. An advance help shorten a shingles infection and cian to make a scheduling plan for your Organization network. You may pay less out 200 IUs per 8-ounce cup. claim review is recommended whether you go lessen the chance of complications. For vaccinations. of your own pocket when you choose a net- work provider. The Aetna Preferred Provider to a PPO dentist or a nonparticipating dentist. most healthy people who receive treat- In the event your doctor finds Organization includes licensed dentists. A It’s voluntary and is not necessary for emer- ment soon after the outbreak of blisters, What is my cost for the vaccination? that you have low vitamin D levels, list of network providers also is available gency treatment or routine care such as teeth the lesions heal, the pain subsides within You’ll be charged a $10 copayment when vitamin D supplements may be through the DocFind® feature on Aetna’s Web cleaning or check-ups. three to five weeks, and the blisters often the vaccine is administered by an covered by the Fund with a pre- site at www.aetna.com. When making an ap- leave no scars. Antiviral drugs, which in- in-network provider. Additional costs scription. pointment, always verify that the dentist is an Take advantage of your dental benefits will apply if obtained out-of-network. clude acyclovir, valcyclovir, or famcyclo- Aetna PPO provider. through the Fund by visiting your dentist Scientists say that up to 41 per- vir will reduce the duration of shingles twice a year, and while you’re there, talk to cent of American adults don’t get and may also help stave off the painful Please call the Benefits Fund with In-network option your dentist for specific advice on improving sufficient levels of vitamin D, but after-effects of shingles. any questions you may have about the • Diagnostic and preventive care are your dental health. For questions or service with these additions to your diet shingles vaccination and your eligibil- covered at no cost. regarding your dental benefits, contact the and a vitamin D supplement you Preventing shingles ity as a participant (877) RN BENEFITS • Basic restorative services, endodontics, Benefits Fund at (877) RN BENEFITS [762- won’t likely be one of them. - FYB Preventative measures, like vaccines, [762-3633] - FYB periodontics, maintenance of prosthodon- 3633]. - FYB will help you avoid contracting a case of tics, and oral surgery are paid at 80 percent New York State Nurses Association Non-Profit Org. It’s heart health US Postage N Y S N A PAID month: Do you Benefits Fund Permit No. 79

Albany, NY -

PO Box 12430 - know the numbers Albany, NY 12212-2430 that count? CHANGE SERVICE REQUESTED hink about all of the numbers Tyou have memorized: phone numbers, birthday dates, pin

numbers, passwords. But there are personalized plan has other numbers you need to know - numbers that are critical to your heart health. These are blood pres- sure, cholesterol, blood sugar and body mass index (BMI). has a BMI calculator, Heart Attack Calcu Attack Heart a BMI calculator, has provides a link allowing you to select your select to your you a link allowing provides - - .

Many serious health conditions women’s on articles links to provides develop slowly over time, but they

can be delayed or prevented if you www. know your numbers. Whether Cool Tools Calculator. Waist and lator, Lifestyles health, health, senior health, children’s health, men’s more. and Topics My topics own interest. of you track them on your smart Plan Improvement Health My condi managing These include you. for just updates health coaching. online and tips, nutrition tions, • • • phone or on a slip of paper tucked • Based health on a tour of the mem of a tour site, ber wellness please visit oxhp.com/materi als/optum1.html -FYB away in a safe place, knowing results, assessment may participants in be enrolled coaching online help to programs their them control you If factors. risk take to like would and comparing your numbers over time can help you and your primary care physician antici- pate potentially dangerous health - - conditions. -

For Your Benefit is published six times each year as a service to Commit these numbers to participants in the New York State Nurses Association Benefits memory, or to the Oxford Health Fund. The information in this newsletter is not intended to be complete plan information, and is not a substitute for the

Assessment Tool (see next article), www.oxhp.

Summary Plan Description. Please address questions regarding free state- This annually, after each physical. this newsletter to the Communications Department. utilize lets you

• Blood pressure with Oxford assessments Health

Ronald F. Lamy, CPA, CEBS, Chief Executive Officer review profile to you allows

• Glucose Christopher J. Rosetti, CPA, CFE, CFF, Chief Operating Officer what’s learn about lets you • Cholesterol (total and Linda M. Whelton, Benefits Department Manager

Tricia E. Cupp, Senior Communications Specialist weight, height, your track can You

HDL) and, section tools and quizzes includes

lets you research a variety of health of a variety research lets you Meighan C. Rask, Communications Specialist, FYB Editor

• Body Mass Index (BMI) Sharron Carlson, CEBS, Communications Representative

NYSNA Benefits Fund

PO Box 12430 spotlight: in the enefit Albany, NY 12212-2430 (518) 869-9501 • (877) RN BENEFITS [762-3633] • (800) 342-4324 Personal Health Record Record Health Personal personal information. edit and information conditions that may pertain to you. pertain you. to may that conditions stats! your Record track for HDL and cholesterol, BMI, blood pressure, the site. utilize purposesing you as Are You at Risk? at You Are a variety for risk at actually are see can if you so you conditions. of A-Z Conditions going on in your body. body. in your on going PersonalizedHealth Center The track and plan you help to health coach online an goals. healthy The Symptom Checker Symptom The

www.rnbenefits.org B und participants can now access the University of of the University access now can participants und on tool Assessment Health Michigan • • • • • •

If you’ll be changing your address, please notify us so partici for virtual tours offering currently is site The pants to see what’s offered, including: offered, see to what’s pants you won’t miss the next issue of For Your Benefit F com/materials/healthassessment.html. partici help designed is to health assessment of-the-art lifestyle their personal health and about learn more pants choices. and other important communications from the Benefits Fund.