Retired Member
Security Benefits Fund
Sele-Dent, Inc.
One Huntington Quadrangle
Suite 1N09
Melville, NY 11747
1.800.520.3368
Sele-Dent.com
Dental Benefit
Your dental benefits are provided directly by The Security Benefits Fund and administered by Sele-Dent.
Annual Coverage Limits
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Family members: $1,500 per person per calendar year (January–December)
Using a Sele-Dent Provider (Recommended)
You may find a participating Sele-Dent dentist at sele-dent.com or by calling 800.520.3368.
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All Sele-Dent providers accept the plan’s fee schedule as full payment
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No out-of-pocket costs unless:
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You exceed your $1,500 annual cap, or
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You choose a non-covered procedure
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Using a Non-Panel Dentist
If you choose a dentist who does not participate in the Sele-Dent network:
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You or your provider will be reimbursed at the panel fee schedule
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You may be responsible for any balance billed
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Speak with your dentist in advance to understand potential costs
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You may be required to pay the full bill upfront and submit for reimbursement
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Claims must be received within 90 days of the date of service
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If your dentist submits the claim for you, confirm they meet the deadline
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All required dental forms are accepted; you are not required to bring forms with you
Orthodontic Benefit
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Lifetime maximum: $1,000
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Eligible dependents: Ages 9–18
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Sele-Dent offers access to Board-Certified Orthodontists
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Typical orthodontic case cost: $2,400–$3,300
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Preferred orthodontist locations available at sele-dent.com
Covered Services & Frequency
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Panoramic X-ray: 1 per year (per member/dependent)
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Full oral exam, full X-ray series & cleaning: Once every 6 months
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Full dentures: Replaceable once every 5 years
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Partial dentures or fixed bridges: Replaceable once every 3 years
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Procedures over $400: Require pre-authorization before treatment begins
Identification Requirements
To be seen by a participating Sele-Dent provider, you must present:
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Photo ID or driver’s license
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Last 4 digits of the member’s Social Security number
⚠️ Do not provide your full Social Security number.
If there is an issue, ask the dental office to contact Sele-Dent and speak with Paul.
Important Tip
If you use an out-of-network dentist, always request a cost estimate before work begins.
General Vision Services (GVS)
Optical Benefit
Your optical benefits are provided by the Security Benefits Fund through General Vision Services (GVS). Participants and their eligible dependent children are entitled to optical benefits once every 12 months. Eligible spouses are entitled to the benefit once every 24 months.
As a Retiree you are entitled to either use the voucher system or after verifying with the Benefit Office that you are eligible, you may pursue the Benefit through a place of your choosing, paying the bill and then sending us a copy – for which you will be reimbursed up to $175.00.
The voucher is worth between $150 – $200 depending on the store. It includes a comprehensive eye exam, frames and prescription lenses. Regular contact lenses can be received instead of glasses. Any charges over that amount will be the patients’ responsibility.
When you use a GVS Optical Provider, you receive the following vision benefits at no cost to
you, unless otherwise noted.
Comprehensive Eye Exam
Even if you do not wear glasses, regular eye exams help protect your eyesight.
Eye examination by a Doctor of Optometry*
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Determines your vision prescription
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Helps detect conditions such as:
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High blood pressure
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Diabetes
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Retinal disorders
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Corneal disorders
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Includes cataract and glaucoma screening
Frames
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Wide selection of frames
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Any style, color, or size
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Up to $200 retail value within the GVS Frame Collection
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Member offices may offer frames up to $150
Lenses
Includes first-quality lenses at no cost:
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Single vision
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Conventional bifocal
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Blended bifocal
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Standard progressive
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Polycarbonate
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Cataract
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Trifocal
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Safety and oversize lenses
Tints & Coatings
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Cosmetic and prescription sunglass tint
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UV protection
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Scratch-resistant coating
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Anti-reflective coating
Contact Lenses (In Place of Eyeglasses)
You may choose contact lenses instead of eyeglasses:
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Standard soft daily wear or extended wear spherical lenses
OR -
6-month supply of basic disposable contact lenses
(4 boxes / 24 lenses)
Special Surcharges
The following options are available for an additional cost:
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Transition III Brown & Grey
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Single vision: $40
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Bifocal: $75
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Progressive: $175
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Transition III Hi-Index
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Single vision: $144
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Bifocal: $160
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Progressive: $212
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Important Notes
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Appointments are required; doctor hours may vary from store hours
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Any services or materials beyond plan benefits are the responsibility of the patient
Added Value Savings
Additional services may be available at discounted rates.
These services are not covered by your vision plan.
Prescription Drugs
Your prescription drug benefit is provided by the Fund and administered by either EmpirRX Health or Humana, depending on age.
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Under 65 = EmpireRX
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Age 65 or older = Humana
EmpireRX PrescriptionDrug Plan (PDP)
Humana PrescriptionDrug Plan (PDP)
Fagenson & Puglisi,
Attorneys at Law
450 Seventh Ave., Suite 704
New York, NY 10123
212.268.2128
Limited Prepaid Legal
Legal services for retirees residing with in the 5 boroughs, Nassau, Suffolk & Westchester counties are:
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Simple will
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Purchase or sale of principal residence
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Defense of misdemeanor or crime violations in state court
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Defense of housing court actions for tenants
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Chapter 7 Bankruptcy fillings
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Uncontested Divorces
Symetra Life Insurance Company
Term Life Insurance
and Accidental Death & Dismemberment (AD&D)
The CWA Local 1183 Benefits Fund provides Basic Term Life Insurance and Accidental Death and Dismemberment (AD&D) coverage at no cost to eligible members. This benefit is provided through Symetra Life Insurance Company and offers financial protection for your designated beneficiary in the event of your death.
The Benefit
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$10,000 in life insurance coverage
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If you die from any cause while insured, your designated beneficiary(ies) will receive the full benefit amount
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Benefits do not reduce due to age
Eligibility
You are eligible for this benefit if:
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You are a retiree member of the CWA Local 1183 Benefits Fund
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You are not on a leave of absence at the time of death
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The City of New York is actively contributing to the Fund on your behalf
Important: Dependents are not eligible for this benefit
Enrollment
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Coverage is automatic for eligible members
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You must designate a beneficiary if you have not already done so
Effective Date
Coverage becomes effective subject to the terms and conditions of the insurance policy.
Beneficiary Designation
A beneficiary is the person(s) or legal entity you name to receive the benefit in the event of your death.
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You may name or change your beneficiary at any time
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Beneficiary designation forms are available from the Fund Office
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Your selection is legally binding
Termination of Coverage
Your life insurance coverage will end under the circumstances described by the Fund and the insurance policy, including if eligibility requirements are no longer met.
If your life insurance coverage ends, you have the right to convert your group life insurance to an individual policy. Conversion must be completed within 31 days
Important Plan Information
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This is a term life insurance plan and includes certain limitations and exclusions
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Some provisions may vary depending on policy terms
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A certificate of insurance will be issued once the group policy is in effect and will provide full details
This summary is provided for informational purposes only and does not constitute a contract. In the event of any discrepancy between this summary and the insurance policy, the policy provisions will govern.