COBANC Supplemental Plan Description
COBANC Supplemental Healthcare Benefits Enrollment
Please see a delegate or stop by the COBANC office for a Health & Welfare Enrollment/Information Card. Be sure to fill out a new form each time you add a dependent or change your address. Enrollment of a dependent requires your card to be accompanied by a copy of the marriage certificate, birth certificate, or Domestic Partner Application (see link below). Please remember to sign and date your card.
Dental Care Benefits
- Group Numbers for Dental Providers
- GG-489A2 – Full-Time Members
- GG-489P2 – Part-Time Members
- GG-489R2 – Retired Members
- To Locate a Dental Provider click the link below and enter your Group Number.
Locate a Dental Provider
Vision Care Benefits
COBANC offers vision benefits through four different networks. The choice of network is yours. Out-of-Network vision care benefits will be paid according to the schedule listed in your benefit book.
The first time you or your covered dependent visits a vision care provider, they will verify your eligibility within the network they belong to. Our claims processor, Healthplex, makes every effort to provide your eligibility to these networks in advance, but there are various reasons your information may not be in their records. For this reason, it is recommended that you ask the provider to verify your eligibility in advance of your first visit.
- Vision Screening
Includes many Independent stores.
To locate a store within the Vision Screening network and see the benefits provided through this network click the appropriate link below.
Vision Screening Locations
Vision Screening Benefits
- General Vision Services
Includes GVS brand plus many Independent stores.To locate a store within the GVS network and see the benefits provided through this network click the link below and enter your Benefit Number.Benefit Numbers for GVS7521 –Active Full-Time Employee7520 –Active Part-Time Employee7502 –Range Instructors7522 –Retiree
Includes Visionworks brand plus many Independent stores.
To locate a store within the DavisVision network and see the benefits provided through this network click the appropriate link below.
DavisVision Active Full-Time Employee Benefits
DavisVision Active Part-Time Employee Benefits
DavisVision Range Instructor Benefits
DavisVision Retiree Benefits
- Supplemental Benefits Services Inc
Includes many Independent stores.
To locate a store within the Supplemental Benefits network and see the benefits provided through this network click the appropriate link below.
Supplement Benefits Services
Hearing Aid Benefits
Many primary healthcare providers, such as The Empire Plan, offer coverage for hearing aids. The COBANC Hearing Aid Benefit is a reimbursement towards the uncovered amount (See the Health & Welfare Plan Booklet for details). In order to process your claim efficiently, please remember to submit the Explanation Of Benefits from your healthcare provider together with the Hearing Aid Claim Form.
Healthcare Claim Forms
All claim forms, except the Maternity/Adoption Claim, should be submitted to Healthplex by mail (see form for address), email (email@example.com), or fax (516-542-2614).
- Dental Care Claim Form
- Vision Care Claim Form
- Laser Vision Correction Claim Form
- Hospital Income Benefit Claim Form
- Maternity/Adoption Claim Form
- Hearing Aid Claim Form
- Prescription/Medical Copayment Reimbursement Form
- Supplemental Workers’ Compensation Disability Claim Form
World Trade Center Sick Leave
If you participated, even on a voluntary basis, in the World Trade Center rescue, recovery or cleanup operations and have since developed a qualifying World Trade Center condition, as defined in section two of the Retirement and Social Security Law, you may be eligible for sick leave at full pay and without charge to accruals for absences due to this condition (“WTC Sick Leave”). Eligible employees may be entitled to restoration of prior sick leave accruals. Filing is a 2-step process. The deadline to file the first step is September 11, 2022. Please click the links below for detailed instructions and forms.