PSC-CUNY WELFARE FUND A Program of Supplemental Health Benefits provided through negotiated employer contributions

PSC-CUNY Welfare Fund Supplemental health benefits for the 24 New York City senior and community colleges Professors and professionals Retirees Staff of 12 support 20,000 active and retired members Funded on a per member basis Agreement between the PSC and CUNY Our funding is limited

Basic and Contributory Plans Prescription Rx Long-Term Disability Dental Vision Extended Medical Hearing Aid Survivor ($2,500) Contributory Extended LTD Life Insurance* Long-Term Care* *NYSUT plans

Prescription Drug The CVS/Caremark program applies to all plan participants who have basic NYC Health Benefits Program coverage, except those who enroll in CIGNA or GHI-HMO and elect the Rx drug benefit rider. Prescriptions may be filled through retail pharmacies or mail order. Injectable and Chemotherapy medication is under PICA, a separate, NYC program with its own Card. Diabetic meds are covered by CUNY basic health plan

Prescription Drug CVS/Caremark Maintenance Drugs 90-day supply of medication, available at retail (CVS pharmacy only) or mail order Generic Drugs : 20%* coinsurance with a $5.00 minimum Preferred Formulary** Drugs : 20%* coinsurance with a $30.00 minimum Non-preferred Formulary** : 20%* coinsurance with a $60.00 minimum _________________________ * whichever is greater ** CVS/Caremark drug list is available on our website, psccunywf.org

Prescription Drug Retail Pharmacy Acute Care Drugs : up to 30-day supply of medication Generic Drugs : 20%* coinsurance with a $5.00 minimum Preferred Formulary** Drugs : 20%* coinsurance with a $15.00 minimum Non-preferred Formulary** : 20%* coinsurance with a $30.00 minimum * whichever is greater ** CVS/Caremark drug list is available on our website, psccunywf.org

Prescription Drug Rx Stipend Program Some basic health insurance includes Drug Benefit Rider The PSC-CUNY Welfare Fund provides a stipend to offset the cost of the Rider. Persons with : CIGNA, HIP Prime POS or GHI-HMO will be automatically enrolled by the Fund Office if “yes” is checked on Health Benefits enrollment form.

Long-Term Disability Standard Life Insurance Co. Coverage (for Full-Time employees only) after completing one year of service Begins 1st of month following six consecutive months of total disability Pays 50% of the pre-disability salary with a minimum of $1,250 monthly and a maximum of $2,500 monthly Benefits continue to the earlier of five years or age 65

Dental Option A Guardian Dental Guard Preferred Provider Organization-PPO Network Participating panel, but may use any dentist No deductible, annual or lifetime maximum payment Dental Schedule each dental service has a scheduled fee Participating Dentists Charge Reduced Fees Child Orthodontia

Dental Option B Delta Care USA 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 Child Orthodontia

Extended Medical ASO PSC-CUNY Program Deductible Coinsurance 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% 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 Limited to Active Employees Designated beneficiary is entitled to $2,500

Vision Davis Vision Benefits available once every 24 months Plan includes eye exam, frames and most lenses Davis Vision, Visionworks "Off Year" benefit for dependent children under 19 Direct reimbursement Plan Up to $200 for prescription glasses purchased through a non-participating provider

Hearing Aid HEARUSA In-plan Hearing Aid Benefit $1,500 per ear every 36 months Guaranteed price discounts on all hearing aids Loaner hearing aids available when your hearing aids are being serviced 3-Year Warranty: repair and one-time replacement due to loss or damage 3-Year supply of batteries 12-Month interest free financing

Contributory Plans Optional = Member Pays Enhanced Long Term Disability (Full-time only) Term Life Insurance (via NYSUT Member Benefits) Long Term Care Insurance (via NYSUT Member Benefits)

Enhanced Disability Benefit Optional Enhanced Disability Benefit Standard Life Insurance Co. 60-Day application window after first anniversary of date of hire. Otherwise requires medical questionnnaire. Disability pay increases from 50% to 60% of the pre-disability 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 pre-disability salary (Minimum of $100 monthly)

Optional Life Insurance New York State United Teachers (NYSUT) Member Benefits Trust-endorsed term life insurance 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

How to Contact Your Fund By Phone (212) 354-5230 or Fax (212)354-5363 By Our Website, psccunywf.org Links to Benefit Vendor sites Summary Plan Descriptions Applications & Claim Forms Practical, Useful Benefits Information

We are here for Assistance & Advocacy psccunywf.org (212) 354-5230

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