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Tier 6 Benefit Information
Benefits Explanation Book
Benefits Book
Benefits Sheet
Benefits Sheet
Getting Reimbursed for Copays -Find and Print Your EOB's (explanation of benefits) Online
Hospital and Related Expenses EOB's - Register Here
Medical/Surgical/Dr. Visits EOB's - Register Here *Group # 030500
Prescription Drug Claims, Balances and History - Register Here
Mental Health and Substance Abuse EOB's - Register Here
Understanding Your EOB
Reimbursement Form
Reimbursement Deadline
Dental
628 Dental Claim Form
Participating Dentists
Explanation of Dental Benefit
Examples of Acceptable Dental Reimbursement Claims Submitted to Local 628
Participating Provider Co-Payment
Explanation of Participating Provider Co-Payment Benefit
Examples of Acceptable Participating Provider Co-Payments Submitted to Local 628
Maternity - Adoption
Prescription Drug
Explanation of Prescription Drug Benefit
Examples of Acceptable Prescription Drug Reimbursement Claims Submitted to Local 628
Out-of-Network Reimbursement
Explanation of 20% Out-of-Network Reimbursement
Explanation of Out-of-Network Major Medical Deductible Reimbursement
Examples of Acceptable 20% Out-of-Network Claims Submitted to Local 628
Vision
Explanation of Benefit
Participating Providers
Vision Care Expense Claim Form
Commonly Asked Vision Questions
Physical Incentive
Explanation of Benefit 2017
Examples of Acceptable Physical incentive Reimbursement Claims Submitted to Local 628
NY Sports Club Discount Membership
Marriage, Baby, Divorce Checklists
Newlywed Checklist
New Baby Checklist
Divorce Checkilst
207a Forms and Info
207a Instructions for Filling Out
207A Contractual Procedures and Deadlines
YFD 207a Application
State Form
Requesting that 628 Fund a Charity Event, Sports Team, Etc.
Charitable Events and Organizations
Sports Teams, Clubs, etc.
Application for Donation
Important Links
Sept. 11 Victims Compensation Fund
Photo Gallery at Webshots.com
Important Forms
UFOA Standard Life Forms
FireFighter Standard Life Forms
Dependant Membership Update Form
VisionCare Form
Important 207a Information
207a Procedures and Deadlines
Dental Form
Events Calendar
Eboard Calendar
Endorsements
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Member Home
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Tier 6 Benefit Information
Benefits Explanation Book
Benefits Sheet
Getting Reimbursed for Copays -Find and Print Your EOB's (explanation of benefits) Online
Reimbursement Form
Reimbursement Deadline
Dental
Participating Provider Co-Payment
Maternity - Adoption
Prescription Drug
Out-of-Network Reimbursement
Vision
Physical Incentive
Marriage, Baby, Divorce Checklists
207a Forms and Info
Requesting that 628 Fund a Charity Event, Sports Team, Etc.
Important Links
Photo Gallery at Webshots.com
Important Forms
Events Calendar
Eboard Calendar
Endorsements
Capt. Kenneth Gallagher
Jan 04, 2012
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IAFF Local 628
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