Hearing Aid
Members are entitled to reimbursement of hearing aids at a maximum of $500 per ear every 4 years.
Please complete this form and return back to the DEA Health Benefits office with an itemized reciept.
Life Insurance
If you would like to purchase an optional life insurance policy, please contact Mechanic & Associates at (845) 624-3800 or visit their website at www.mechanic-insurance.com.
GVS Contact Lens Flyer
Benefits offered through General Vision for Contact Lens Replacement
Student Verification
Have this form completed and returned back to the DEA in order for student children between the ages of 19-23 to maintain their dental, optical and prescription coverage.
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Please note if the child is reaching the age of 23 or not attending school full time, you can contact the DEA Health Benefits Office to inquire about COBRA to maintain benefits at a cost.
Member/Dependent Information – Add/ Remove/Change
Complete this form to update (add/remove) your dependents, change your name or to update your address for your dental, optical and prescription benefits.
If you are adding or removing dependents please make sure to attach required documentation (Marriage Cert., Birth Cert., Divorce Papers, Death Cert. etc)
If you are adding a step-child please contact the DEA Health Benefits Office.
Prescription Reimbursement (Capital RX)
Complete this form and return to Capital Rx. If you have paid out of pocket for the full cost of your prescription, in order to receive reimbursement.
Cigna Dental Claim
Complete this form and return to CIGNA for reimbursement for out of network dental services.
(For Dental Services done prior to 09/01/2026)
Annuity Beneficiary
Complete this form and submit if you would like to update your DEA annuity beneficiaries.
Life Insurance Beneficiary
Complete this form to update your life insurance beneficiaries.
