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

2. Eligibility for Benefits
Employee of the City University of New York
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

3. Covered Titles Instructional Staff Classified Managerial Staff
College Laboratory Technicians
Higher Education Officer series
Full-time Faculty titles
Continuing Education Teachers
Classified Managerial Staff
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

4. Enrollment Process
Complete the PSC-CUNY Welfare Fund Enrollment Form which is available from the Human Resources / Personnel Office
Submit acceptable documentation to support the eligibility status of dependents [spouse and children]
PSC-CUNY WELFARE FUND

5. Effective Date of Coverage
PSC-CUNY Welfare Fund benefits begin on the st 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.
If the Human Resources Department does not receive the required forms within 31 days the appointment date, benefits may be delayed or lost.

6. Basic and Contributory Plans
Prescription Rx
Long-Term Disability
Dental
Extended Medical
Death
Vision
Hearing Aid
Contributory
Optional LTD Rider
Catastrophic Medical
Life Insurance
Long-Term Care

7. 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.

8. 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
_________________________
* whichever is greater
** list is available from Medco

9. 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%
____________________
* whichever is greater
** list is available from Medco

10. 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

11. Prescription Drug Rx Stipend Program [Non-Medco]
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 : HIP-POS, Aetna QPOS, Aetna HMO, CIGNA or GHI-HMO will be automatically enrolled by the Fund Office if “yes” is checked on ERB.

12. Long-Term Disability Standard Life Insurance Co.
Coverage 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

13. 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

14. 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

15. 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

16. Death Benefit Limited to Active Employees
Designated beneficiary [listed on the Green Card] is entitled to $2,500

17. 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

18. 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.
No charge if GVS is notified at the time of service.
Percentage discount if Davis Vision is notified at the time of service.

19. Hearing Aid Benefits available once every 36 months
Direct reimbursement of up to $500
Special Program with the Speech & Hearing Center of Brooklyn College
General Hearing Services [affiliated with GVS]

20. Contributory Plans Optional = [Member Pays]
Enhanced Long Term Disability
Catastrophic Major Medical
Term Life Insurance
Long Term Care Insurance

21. Enhanced Disability Benefit
Optional
Enhanced Disability Benefit
Standard Life Insurance Co.
60-Day Window after hire. Otherwise requires physical.
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)

22. Catastrophic Major Medical
Optional
Catastrophic Major Medical
Marsh Affinity [via US Life Insurance Co.]
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)

23. Life Insurance New York State United Teachers (NYSUT) Optional
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

24. Long-Term Care John Hancock Life Insurance Co.
Optional
Long-Term Care
John Hancock Life Insurance Co.
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

25. Long-Term Care Optional 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
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)

26. How to Contact Your Fund
By Phone (212) or Fax (212)
By Website : PSCCUNYWF.org
Website Provides linkages to benefit carriers
Website provides Summary Plan Description
Website provides Downloadable Forms
Website provides linkages to Employer basic carriers

27. A Few Points for New Employees to Remember
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 ]

28. continued…..
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 Re-opener. With Delta, you must also select a provider.

29. 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:
Long-Term Care : days from DOH
Enhanced Disability: Days from 1st DOH Anniversary
DOH = Date of Hire

30. Also remember
Changes to GHI Optional Rider (which can reduce the Extended Medical deductible) CAN ONLY BE MADE DURING THE CITIWIDE ANNUAL RE-OPENER.
AND Finally:
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!

31. We are here for Assistance & Advocacy
PSCCUNYWF.org (212)
61 Broadway 15th Floor NY,NY 10006