Employees Security Fund Medical, Prescription Drug and Dental Plan (for members of the Fixture, Manufacturing, or Supply Divisions)

The Employees’ Security Fund (ESF) Health and Welfare Medical Plan offers two levels of coverage: Plan “A," and Plan “C.” The level of coverage that applies to you is determined by the collective bargaining agreement held with your employer. The information provided below provides the highlights of the ESF Health and Welfare Plan applicable to both levels of the Plan, unless otherwise noted. For a detailed schedule of covered expenses under each plan, please refer to the appropriate section of the Summary Plan Description.

Plan Overview

You are eligible after 26 consecutive weeks of full-time work. Thereafter, at least 26 weeks of contributions out of the past 52 must be received in order for you to remain eligible. If you are unemployed during all or any portion of this time, you must be registered as available for employment. To be eligible, you must complete an enrollment form and submit applicable documentation.

If you are a retired participant, you and your eligible dependents are only eligible for dental, optical, prescription drug and annual diagnostic medical benefits.

You can cover your spouse and children. Once you meet the eligibility requirements and enroll, you are able to cover your spouse and dependent children according to the rules of the Plan.

If you are covered under Plan C, you will have lower out-of-pocket expenses when you use a provider who participates in the MagnaCare Preferred Provider Organization.

To find a MagnaCare network provider, use the MagnaCare Provider Locator tool. You can also obtain a list of participating providers by contacting MagnaCare at (800) 548-0138.

You will have lower out-of-pocket expenses if you use a provider who participates in the MagnaCare Preferred Provider Organization. You can obtain a listing of these participating providers by contacting MagnaCare at (800) 548-0138 or www.magnacare.com.

Plan C requires pre-notification of certain services including hospital admissions and any surgical procedure performed at a hospital or surgi-center (both in-patient and out-patient).

Plan A does not require pre-notifications.

Plan A and C Benefits

Plan A: In-patient and out-patient hospital charges, as well as, surgical and other benefits are covered. Read the Plan A highlights brochure for more details.

Plan C: Most services are covered within the MagnaCare network. Physician's office visits (for non-preventive care) are covered in and out of network and are subject to a $50 co-payment. Read the Plan C highlights brochure for more details.

Retail Pharmacy

The Express Scripts Network covers the cost of prescriptions, except for the applicable co-pay:

  • Generic: $15
  • Plan-Preferred Brand Name: $25
  • Non-Preferred Brand Name: $40

Express Scripts Mail Service

If you are using a maintenance medication to treat illnesses such as high blood pressure or arthritis, you can have your prescription filled for a 90-day supply through the mail-order program. The cost to you is only the applicable co-pay:

  • Generic: $45
  • Plan-Preferred Brand Name: $75
  • Non-Preferred Brand Name: $120

Use a network provider. If you and your eligible dependents use a dentist who participates in the DDS, Inc. panel, your out-of-pocket expenses will be limited and you will not have to submit a claim form.

The dental benefit includes:

  • a $1,500 annual maximum on all dental work performed in a single calendar year(excluding pediatric); and
  • a $50 annual deductible on serves that are not preventative or basic.

To find a dentist who participates in the DDS panel, call (800) 255-5681 or log on to http://www.ddsinc.net/ (password: 3)

If you use a non-DDS provider, out-of-pocket expenses are your responsibility.

Get a free check-up. You and your eligible dependents can receive an annual physical exam for diagnostic purposes only. This exam is available through any of the following:

  • JIB Medical, P.C.
  • Diagnostic medical services available at an approved facility located in New Jersey or Long Island

Free exams and eyeglasses. If you use JIB Medical, P.C. at JIB, you and your eligible dependents can receive an annual eye exam and, if prescribed, one pair of eyeglasses at no cost. You do not need to file a claim for this benefit.

If you use an optical provider who belongs to either the Vision Screening Panel or the approved New Jersey panel, covered benefits will be paid in full. To obtain benefits from a panel provider please contact the Fund Office at (718) 591-1100 to request an optical voucher.

If you receive vision benefits outside the Medical Department, you will be responsible to pay any applicable expenses.

Plan Information

Plan Name: Employees Security Fund of the Electrical Products Industries

Plan Identification Number: 13-6100908

Plan Number: 501

Plan Year: January 1 through December 31

Type of Plan: This Plan is a self-insured, self-administered employee welfare benefit plan under which participants are covered for certain services related to their health.

Plan Administrator: Joint Industry Board of the Electrical Industry

FAQs Icon
Frequently Asked Questions

Where can I go for a vision exam and what services are covered under the ESF Medical Health & Welfare Plan?

The vision benefit entitles you, your legal spouse and eligible children to an eye examination once each year by an optometrist or an ophthalmologist and, if prescribed, one pair of eyeglasses each year. You may receive vision care services in the following ways:

  • Optical services (optometrist for examination and optician for eyeglasses) at JIB Medical, P.C. (located at the address below). If you go to JIB Medical, P.C., there will be no charge to you and you do not have to file a claim form with: 

        Electrical Industry Center,
        158-11 Harry Van Arsdale 
        Jr. Avenue, Room 201
        Flushing, NY 11365 

    To schedule an optical appointment, contact JIB Medical P.C. at (718) 591-2014 from Monday-Friday, 8:00 A.M. to 8:00 P.M. and Saturday from 8:00 A.M. to 3:00 P.M. Appointments should be made approximately 2 weeks in advance.
  • You may also use a provider who belongs to the Vision Screening Optical Group. These providers offer optometric eye care to participants, their legal spouses and eligible children living in New York, New Jersey and Florida. Their service includes one eye examination by an optometrist and, if prescribed, a pair of eyeglasses (mono-focal or bi-focal) and a selection of frames once a year. If you use this method and you buy supplies or services for which you are not eligible or covered, you will be responsible to pay these charges, but you will receive a 20% discount. To use a Vision Screening provider, please contact the Fund Office at (718) 591-1100 to request an optical voucher. OR
  • You may also use a panel optical provider located in New Jersey. Their service includes one eye examination by an optometrist and, if prescribed, a pair of eyeglasses (mono-focal or bi-focal) and a selection of frames once a year. If you obtain the benefit in this way there will be no charge to you. You do not have to file a claim form. Please contact the Fund Office at (718) 591-1100 to request an optical voucher for a New Jersey panel provider. OR
  • You may have an eye examination by any other optometrist or ophthalmologist, licensed and practicing in the United States or its possessions. You may purchase eyeglasses, if necessary, from any licensed facility operating in the United States or its possessions. If you use this method, you must file a claim form with the Fund Office. The Plan will reimburse you or your optical provider according to the Plan’s fee schedule.

View All Employees Security Fund Medical, Prescription Drug and Dental Plan (for members of the Fixture, Manufacturing, or Supply Divisions) FAQs