Ohio AFSCME Care Plans

 

Below is a list of all Care Plans available. For details simply click the plus sign (+) on the right.

Dependent child eligibility to age 28 for all benefits excluding Life Insurance I and II and Legal Benefits

Life Insurance Benefit Level I
  • Coverage in amounts between $14,000 and $30,000
  • Accidental Death and Dismemberment Benefit
  • Dependent Coverage- $2,000
  • Spouse coverage – $2,000
  • Child coverage – $2,000 to age 19 (up to 23 years if full-time student)
  • Disability Life Insurance Extension
  • Accelerated Death Benefit
  • Seat Belt Benefit
Life Insurance Benefit Level II
  • Amount of Life Insurance – Member $50,000
  • Amount of Accidental Death & Dismemberment $26,000
  • Dependent Coverage – $2,000
  • Spouse coverage – $2,000
  • Child coverage – $2,000 to age 19 (23 years if a full-time student)
  • Disability Life Insurance Extension
  • Accelerated Death Benefit
  • Seat Belt Benefit
Prescription Drug Health Reimbursement Account Plan

 

  • Covers Employee, Spouse and Dependent Children.
  • 90% reimbursement on each prescription.
  • $600.00 maximum each year per family member.

 

Prescription Card Plan

 

  • Covers Employee, Spouse and Dependent Children.
  • Plan covers 90% of the cost of the prescription.
  • Co-pay of 10% of cost at the pharmacy.
  • $5,000.00 maximum each year per family member.
  • An employer can agree to make contributions to the Care Plan to provide coverage for the cost of prescription drugs in excess of the $5,000.00 maximum each year on an individual basis.
Vision Care Benefit Level I
  • Covers Employee, Spouse and Dependent Children. Adults once every 24 consecutive months and children under the age of 19 once every 12 consecutive months.
  • Covers Exam (including Glaucoma testing), standard frames, basic single vision, bifocal or trifocal lenses at no cost when provider network used.
  • Provides an allowance for contact lenses.
Vision Care Benefit Level II
  • Covers Employee, Spouse and Dependent Children once every 12 consecutive months.
  • Covers Exam (including Glaucoma testing), standard frames, basic single vision, bifocal or trifocal lenses at no cost when provider network used.
  • Provides an allowance for contact lenses.
Vision Care Benefit Level III
  • Covers Employee, Spouse and Dependent Children once every 12 consecutive months.
  • Covers Exam (including Glaucoma testing), standard frames, basic single vision, bifocal or trifocal lenses at no cost when provider network used.
  • Provides an allowance for contact lenses.
  • Covers Poly-carbonate lenses, no-line bifocals, ultra light lenses, tints, and scratch coating.
Hearing Aid Benefit
  • Covers Employee, Spouse and Dependent Children(Benefits are payable once every 4 years).
  • $1,500.00 toward the purchase of a Hearing Aid, Ear Mold and the services of an Audiologist for each ear.
Dental Care Benefit Level I

This Plan is no longer available for new policies

  • Covers Employee, Spouse and Dependant Children.
  • Open Panel (Choose your own dentist)
  • Payment according to fee schedule
  • No deductible
Dental Care Benefit Level II
  • Covers Employee, Spouse and Dependent Children
  • Open Panel (choose your own dentist)
  • Payment according to fee schedule
  • $1,500.00 Orthodontic Benefit for Dependent Children under the age of 19
  • Annual Maximum Benefit – $4,000.00 per each family member. No deductible.
  • $1,500 lifetime maximum for implant services
Dental Care Benefit Level II-A
  • Covers Employee, Spouse and Dependent Children
  • Open Panel (choose your own dentist)
  • Payment according to enhanced fee schedule
  • $1,500.00 Orthodontic Benefit for Dependent Children under the age of 19
  • Annual Maximum Benefit – $4,000.00 per each family member. No deductible.
  • $1,500 lifetime maximum for implant services
Dental Care Benefit Level III
  • Covers Employee, Spouse and Dependent Children
  • Open Panel (choose your own dentist)
  • Payment will be made based on applying the following schedule of benefit percentages to the lesser of the UCR or the actual amount charged.
  • Diagnostic/Preventive 100% UCR
  • Minor Restorative 80% UCR
  • Major Restorative 50% UCR
  • $2,000.00 Orthodontic Benefit for Dependent Children under the age of 19
  • Annual Maximum Benefit – $4,000.00 per each family member. No deductible.
  • $2,000 lifetime maximum for implant services
Dental Care Benefit Level IV
  • Covers Employee, Spouse and Dependent Children
  • Open Panel (choose your own dentist)
  • Payment will be made based on applying the following schedule of benefit percentages to the lesser of the UCR or the actual amount charged.
  • Diagnostic/Preventive 100% UCR
  • Minor Restorative 80% UCR
  • Major Restorative 60% UCR
  • $2,000.00 Orthodontic Benefit for Dependent Children under the age of 19
  • Annual Maximum Benefit – $4,000.00 per each family member No deductible
  • Certificate booklets which contain a complete description of the covered benefits and any exclusions, are available from any Ohio AFSCME Care Plan office.
  • $2,000 lifetime maximum for implant services
Employee Assistance Program Level I
  • Covers Employee, Spouse and Dependent Children
  • Provides confidential counseling and referral assistance 24/7
  • Phone counseling by masters and doctoral-level clinicians – up to 3 calls per problem per year
  • Password protected online access to Employee Assistance related services
Employee Assistance Program Level II
  • Covers Employee, Spouse and Dependent Children
  • Provides confidential counseling and referral assistance 24/7
  • Phone counseling by masters and doctoral-level clinicians – up to three calls or in-person visits per problem per year
  • Password-protected online access to EAP related services
Employee Assistance Program Level III
  • Covers Employee, Spouse and Dependent Children
  • Provides confidential counseling and referral assistance 24/7
  • Phone counseling by masters and doctoral-level clinicians – up to five calls or in-person visits per problem per year
  • Password-protected online access to EAP related services
Legal Benefits
  • Covers Employee, Spouse and Dependent Children
  • Provides various legal services, including wills, living wills, codicils, real estate matters and simple divorce or separation agreements
  • Dependent child coverage to age 19, or age 23, if full-time student