PRESCRIPTION

$3,500 MAXIMUM per calendar year per family

Co-Pays

• $10 Generic
• $15 Preferred Brand
• $30 Non-Preferred Brand

Per presciption(30 days);whether via Pharmacy or mail order

Additional Information & Forms

• Formulary(PDF)

OPTICAL

$200 per calendar year

Additional Information & Forms

• Providers(PDF)

PODIATRY & HEARING AID

Podiatry

NOT COVERED

Hearing Aid

$250 per ear. $500 Maximum Every 5 years

SPOUSAL DEATH BENEFIT

NOT COVERED

LEGAL SERVICES

Call the Union Office for an appointment

Additional Information & Forms

• Legal Service Plan (PDF)

DEATH BENEFIT

$5,000 (member's only)

Any death resulting from the following events below will not be covered

• SUICIDE
• SELF INFLICTED INJURY WHILE SANE OR INSANE
• PARTICIPATION IN OR IN CONSEQUENCE OF HAVING
• PARTICIPATED IN THE COMMITTING A FELONY;
• OR ANY UNLAWFUL ACT
• DRUG ABUSE