Supplemental Health Benefits Provided through Negotiated ......• Preferred Provider Organization...
Transcript of Supplemental Health Benefits Provided through Negotiated ......• Preferred Provider Organization...
PSC-CUNY WELFARE FUND
Supplemental Health Benefits Provided through Negotiated Employer Contributions
Basic and Contributory Plans
Basic
• Prescription Drug • Dental • Vision • Extended Medical (+GHI) • Hearing Aid • Long-Term Disability • Survivor death benefit
Contributory • Extended Long-Term
Disability • Catastrophe Major
Medical* • Long-Term Care*
*NYSUT Plans
Prescription Drug
CVS/Caremark Prescription Plan • For all CUNY NYC HBP health plans • Except CIGNA, HIP Prime POS or GHI-HMO with Rx
Drug benefit Rider •Prescriptions filled by all retail pharmacies or CVS mail • Injectable and Chemotherapy drugs are covered by the NYC PICA Program
•Diabetic drugs are covered by NYC HBP health insurance
CVS Prescription Plan
All Retail Pharmacies (CVS, Rite-Aid, Walgreen, DR)
Acute Care Drugs: up to 30-day supply
• Generics: 20% copay, $5 minimum• At CVS only, $0 Generics,10% copay Generics
• Preferred Formulary: 20% copay, $15 min.• Non-preferred Formulary: 20% copay, $30 min.
Welfare Fund CVS drug list is available on our website, psccunywf.org
CVS Prescription Plan
CVS/Caremark Maintenance Medication90-day supply from CVS pharmacy or CVS Mail
•Generics: $0 Generics or 10% copay Generics
•Preferred Formulary: 20% copay or $30 min.
•Non-preferred Formulary: 20% copay or $60 min. •Hi-Cost Rx Program reimburses up to $25K annually
Prescription Drug
Stipend Program for NYC HBP insurance plans with a Drug Rider • Stipend offsets the cost of the Drug Rider • CIGNA, HIP Prime POS and GHI-HMO
members will be automatically enrolled if Rider is checked on Health Benefits enrollment form.
Dental Plans
Guardian Dental Guard• Preferred Provider Organization Network
• Accepts out-of-network dentists • Participating Dentists Charge Reduced Fees • No deductible, annual or lifetime max • Dental Fee Schedule: % Paid by the Fund • Includes Child Orthodontia
Dental Plans
Delta Care USA• Provides HMO Panel of Dentists • Schedule of charges tells how much you
pay, not what the Fund pays • Cost predictability • Low out-of pocket — No copay for most
preventive services
Vision
❖ In-network benefit every 12 months at Davis Vision, Visionworks & participating Davis network providers
❖ $0 copay for Davis frames or contacts ❖ Eye exam, frames, lenses & coatings ❖ Out-of-network benefit every 24 months —
Reimbursement up to $200
Davis Vision
Hearing Aid
HearUSA • In-plan benefit $1,500 per ear every 36
months • Price discounts on all devices • Loaners when devices are serviced • 3-Year Warranty for loss or damage • 3-Year supply of batteries • Out-of-network benefit: $500 every 3 years
(36 months)
Long-Term Disability
Standard Life Insurance Company•Coverage after one year of service (full-timers) •Payment begins after 6 months of total disability•Pays 50% of the pre-disability salary•Pays $1,250/mo. min., $2,500/mo. max.•Pays 5 years or up to age 65
Extended Medical
Reimbursement for GHI out-of-network costs
Deductibles (out-of-pocket costs) •With GHI Optional Rider: $1,000 individual, $2,000 family •Without GHI Optional Rider: $4,000 individual, $8,000 family
Plan Pays •After deductible is met, Fund pays 60% of allowable charges not paid by GHI
•After annual $3,000 out-of-pocket for individual or $6,000 for family Fund pays 100% of allowable charges not paid by GHI
Death Benefit
• Active & Adjunct Employees • $5,000 Paid to Designated Beneficiary • Death Benefit Beneficiary Card must be
on file with campus or workplace Benefits Office
Optional Extended Long-Term Disability
Standard Life Insurance Company• 60-Day application window one year after date of hire for
guaranteed acceptance. After requires medical form • Payment up 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 • Contributes 10% of pre-disability salary to retirement
account (minimum of $100 monthly)
NYSUT Term Life Insurance
New York State United Teachers Member Benefit• New Full-time employees receive one-year $25,000
term life insurance policy at no cost, with an option to renew after first year. 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
Contact Your Fund & Get Information
➢ Email [email protected] ➢ Phone (212) 354-5230 ➢ Website, psccunywf.org
➢Links & contacts to Benefit Vendors ➢Clear, concise benefit descriptions ➢Applications & Claim Forms ➢Practical, Useful Benefits Information
PSC-CUNY Welfare Fund. Google it!