Transcript New York City College of Technology Personnel Department

PSC-CUNY WELFARE FUND
A Program of Supplemental Health Benefits
provided through negotiated employer contributions
Eligibility for Benefits
Employee of the City University of New York
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Eligible for basic health coverage under the
NYC Health Benefits Program
Full-time Instructional Staff with appointment >6 mos.
Working in a covered title (next page)
Paid from tax-levy funds
Working > 20 hours per week
Covered Titles
Instructional Staff
Classified Managerial Staff
College Laboratory Technicians
Higher Education Officer series
Full-time Faculty titles
Continuing Education Teachers
Administrative Superintendent (B&G)
Assistant College Security Director
Chief Administrative Supt. (B&G)
Chief Administrative Supt. of Campus (B&G)
College Security Director
Computer Operations Manager
Computer Systems Manager
Deputy University Security Director
University Associate Chief Engineer
University Chief Architect
University Chief Engineer
University Security Director
Enrollment Process
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Complete the PSC-CUNY Welfare Fund Enrollment
Form which is available from the Human Resources /
Personnel Office
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Submit acceptable documentation to support the
eligibility status of dependents [spouse and children]
Effective Date of Coverage
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PSC-CUNY Welfare Fund benefits begin on the
1st day of the month following appointment date
[or on the first day of the month, if that is the hire date],
provided that the Enrollment Form and all supporting
documentation is received within 31 days.
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If the Human Resources Department does not receive the
required forms within 31 days the appointment date,
benefits may be delayed or lost.
Basic and Contributory Plans
Basic
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Prescription Rx
Long-Term Disability
Dental
Extended Medical
Death
Vision
Hearing Aid
Contributory
Optional
LTD Rider
Catastrophic
Life
Medical
Insurance
Long-Term
Care
Prescription Drug
The Medco program applies to all Plan participants
except those who have basic health insurance through:
HIP-POS, Aetna QPOS, Aetna HMO, CIGNA or GHI-HMO
and elect the carrier rider.
Prescriptions may be filled through the Medco
Mail order or through an extensive network of
participating Retail pharmacies
Injectable and Chemotherapy medication is under PICA,
a separate, City-administered program with its own Card.
Prescription Drug
Medco Mail Order Service
Maintenance Drugs : up to 100-day supply of medication
Generic Drugs : 20%* coinsurance with a $5.00 minimum
Preferred** Brand-name Drugs : 20%* coinsurance with a $30.00 minimum
Other Brand-name Drugs : 20%* coinsurance with a $60.00 minimum
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* whichever is greater
** list is available from Medco
Prescription Drug
Medco Retail Pharmacy Program
Acute Care Drugs : up to 30-day supply of medication
Generic Drugs : 20%* coinsurance with a $5.00 minimum
Preferred** Brand-name Drugs : 20%* coinsurance with a $15.00 minimum
Other Brand-name Drugs : 20%* coinsurance with a $30.00 minimum
Mail Order is encouraged. If a retail pharmacy is used past a 2nd refill,
the coinsurance increases to 35%
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* whichever is greater
** list is available from Medco
Prescription Drug
Medco Non-participating Pharmacies
Persons who use drug stores not in the Medco Network:
 must pay the full cost of a prescription
 must complete a direct reimbursement claim form
and submit to Medco
 will be reimbursed for a portion of the cost
Prescription Drug
Rx Stipend Program [Non-Medco]
Some basic health insurance includes Drug Benefit Rider
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The PSC-CUNY Welfare Fund provides a stipend to
offset the cost of the Rider.
Persons with : HIP-POS, Aetna QPOS, Aetna HMO,
CIGNA or GHI-HMO will be automatically enrolled by
the Fund Office if “yes” is checked on ERB.
Long-Term Disability
Standard Life Insurance Co.
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Coverage after completing one year of service
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Begins 1st of month following six consecutive months
of total disability
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Pays 50% of the pre-disability salary with a minimum
of $1,250 monthly and a maximum of $2,500 monthly
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Benefits continue to the earlier of five years or age 65
Dental
[Option A]
Guardian Life Insurance Co.
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Preferred Provider Organization-PPO Network
 Participating
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No deductible, annual or lifetime maximum payment
Dental Schedule
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panel, but may use any dentist
dental service has a scheduled fee
Participating Dentists Charge Reduced Fees
Best Reimbursement is for Preventive work
Child Orthodontia
Dental
[Option B]
Delta Care USA
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Provides an HMO Panel of Dentists
“Reverse Reimbursement” Schedule
Tells how much you Pay, not what you get back
Cost predictability, if care is used
Low out-of pocket. Most preventive services free
Adult and Child Orthodontia
Extended Medical
ASO PSC-CUNY Program
Deductible
 For those who purchase the Optional Rider through GHI basic. the
deductible is $1,000 for individual plan and $2,000 for a family plan;
 For those who do not purchase the Optional Rider, the deductible is
$4,000 for an individual plan and $8,000 for a family plan
Coinsurance
 After deductible is met, Welfare Fund Extended Medical pays 60%
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of R&C not paid by basic GHI
After coinsurance outlays exceed $3,000 for individual or $6,000 for
family in a calendar year, Welfare Fund Extended Medical will pay
100% of R & C not paid by GHI
Death Benefit
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Limited to Active Employees
Designated beneficiary [listed on the Green
Card] is entitled to $2,500
Optical
General Vision and Davis Vision
 Benefits available once every 24 months
 Plan includes eye exam, frame and most lenses
 General Vision Services (GVS)
 Davis Vision
 Direct reimbursement Plan
 Up to $100 for prescription glasses purchased
through a non-participating provider
Optical
General Vision and Davis Vision
"Off Year" benefit for dependent children who
have a prescription change in the year following
the use of the benefit.
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No charge if GVS is notified at the time of service.
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Percentage discount if Davis Vision is notified at the
time of service.
Hearing Aid
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Benefits available once every 36 months
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Direct reimbursement of up to $500
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Special Program with the Speech & Hearing Center
of Brooklyn College
General Hearing Services [affiliated with GVS]
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Contributory Plans
Optional =
[Member Pays]
o Enhanced Long Term Disability
o Catastrophic Major Medical
o Term Life Insurance
o Long Term Care Insurance
Optional
Enhanced Disability Benefit
Standard Life Insurance Co.
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60-Day Window after hire. Otherwise requires physical.
Disability pay increases from 50% to 60% of the predisability salary.
Minimum pay increases from $1,250 to $1,500 monthly and
maximum increases from $2,500 to $6,000 monthly
Benefits continue to age 65
If you are a member of TIAA, TRS, ERS or BOERS
Contributions to a TIAA account equal to 10% of predisability salary (Minimum of $100 monthly)
Optional
Catastrophic Major Medical
Marsh Affinity [via US Life Insurance Co.]
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Supplement to basic health policy.
$10,000 deductible
Premium based upon age at time of enrollment
Plan pays up to $2 million for up to ten years for
covered services (medical, surgical & convalescence)
Optional
Life Insurance
New York State United Teachers (NYSUT)
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Term life insurance provided by the NYSUT Trust Fund.
New Full-time employees receive one-year $25,000 term
life insurance policy at no cost, with an option to renew.
Must be new NYSUT member.
Spouses or domestic partners can be covered
Employees under age 65 may apply for added coverage
up to $1,000,000. Physical exam may be required
Policy is portable
Optional
Long-Term Care
John Hancock Life Insurance Co.
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Provides benefits to those unable to care for
themselves because of chronic illness or
severe physical impairment.
Dependents can also be covered
Eligibility – Actives and retirees. Premium
increases with age of initial enrollment
Return of Premium provision
Policy is portable
Optional
Long-Term Care
Other Carriers
The John Hancock Program is negotiated and monitored by
the PSC-CUNY Welfare Fund
There are two other programs available, and all are payable
via payroll deductions
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A Group Long Term Care Insurance Program (offered by the City of
New York)
New York State United Teachers’ Long Term Care Program
(offered by the NYSUT Trust Fund)
How to Contact Your Fund
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By Phone (212)254-5230 or Fax (212)354-5363
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By Website : PSCCUNYWF.org
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Website Provides linkages to benefit carriers
Website provides Summary Plan Description
Website provides Downloadable Forms
Website provides linkages to Employer basic carriers
A Few Points for New Employees to Remember
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Decisions you make now are important. Be certain you
are well-informed
Some decisions are easier to change than others. For
example a Pension decision is for the duration of
employment, Health Insurance can be changed during
an annual re-opener.
Some Decisions – if made sooner- lower periodic
payments [e.g. LTC which stays at a constant premium
based upon age at enrollment ]
continued…..
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Some optional programs adjust premium with age [For
example, optional life insurance goes up by five-year
increments as the insured ages]
Some optional programs adjust premium with age and
salary [For example, the Optional LTD program]
You will need to decide on a Dental Program; either
Guardian or Delta. This option can be changed once
each year during the same time as the City-wide Reopener. With Delta, you must also select a provider.
VERY IMPORTANT : “Guaranteed Issue”
Some optional programs only offer that additional
coverage without evidence of individual insurability
for a limited time.
The time window is:
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Long-Term Care :
Enhanced Disability:
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DOH = Date of Hire
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60 days from DOH
60 Days from 1st DOH Anniversary
Also remember
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Changes to GHI Optional Rider (which can reduce the
Extended Medical deductible) CAN ONLY BE MADE
DURING THE CITIWIDE ANNUAL RE-OPENER.
AND Finally:
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Be aware of COBRA – It has 2 Parts [your Fund and the basic
City (CUNY) coverage]. If you are COBRA-eligible and want
both the basic and the Welfare Fund benefits, you must enroll
in both!
When you leave or RETIRE, let everyone know where you are.
You may be entitled to benefits or have opportunities where
we need to notify you!
We are here for Assistance & Advocacy
PSCCUNYWF.org
(212) 354-5230
61 Broadway 15th Floor NY,NY 10006