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

2. 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

3. 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 (CVS, Duane Reade, Rite Aid, Target, etc.) or mail order.
Injectable and Chemotherapy medication is under PICA,
a separate, City-administered program with its own Card.

4. 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
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* whichever is greater
** CVS/Caremark drug list is available on our website, psccunywf.org

5. 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

6. 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 or GHI-HMO will be automatically enrolled by the Fund Office if “yes” is checked on Health Benefits enrollment form.

7. 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

8. Dental Option A Guardian Life Insurance Co.
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
Best Reimbursement is for Preventive work
Child Orthodontia

9. 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
Adult and Child Orthodontia

10. 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

11. Death Benefit Limited to Active Employees
Designated beneficiary (listed on the Green Card) is entitled to $2,500

12. 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

13. Hearing Aid
HEARUSA
In-plan Hearing Aid Benefit $750 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

14. 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)

15. 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)

16. 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

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

18. We are here for Assistance & Advocacy
psccunywf.org
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