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.
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.
Annuity
If you would like to remove your annuity monies from the DEA complete and return this form. (Retired Members Only)
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)
Medicare B and IRMAA Forms
These forms must be completed and returned back to the Office of Labor Relations.
