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PSC-CUNY WELFARE FUND

PSC-CUNY WELFARE FUND. Supplemental Health Benefits provided through negotiated employer contributions Adjunct Coverage for Individual Members. PSC-CUNY Welfare Fund. Supplemental health benefits for the 24 New York City senior and community colleges Professors and professionals Retirees.

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PSC-CUNY WELFARE FUND

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  1. PSC-CUNY WELFARE FUND Supplemental Health Benefits provided through negotiated employer contributions Adjunct Coverage for Individual Members

  2. 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

  3. Adjunct Benefits • Prescription Rx • Dental • Vision • Extended Medical (w/GHI-CBP) • Hearing Aids Coverage is individual. Family: $190.75/month & Enrollment in Family Basic Health is Required

  4. Prescription Drugs • The CVS/Caremark program applies to all plan participants who have basic NYC Health Benefits Program coverage, except those who enroll inHIP-POS, CIGNA or GHI-HMO and elect the Rx drug benefit rider. • Prescriptions may be filled through retail pharmacies (CVS, Duane Reade, Rite Aid, etc.) or mail order. • Injectable and Chemotherapy medication is under PICA, a separate, City-administered program with its own Card. • Diabetic meds are provided by basic health insurance; GHI covers low-dose statins, preventives, at no cost

  5. CVS Prescription Drug Plan 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

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

  7. Prescription Drugs 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 : HIP-POS, CIGNA or GHI-HMO will be automatically enrolled by the Fund Office if “yes” is checked on Health Benefits enrollment form.

  8. DentalOption A Guardian DentalGuard Preferred • 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 • 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. Vision Davis Vision • Benefits available once every 24 months • Plan includes eye exam, frame and lenses • Davis collection frames & lenses or contacts at no copayment • Direct reimbursement up to $200 for prescription glasses or contacts purchased through a non-participating provider

  12. 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

  13. How to Contact Your Fund • By Phone (212) 354-5230 or Fax (212)354-5363 • By Our Website, psccunywf.org • Website Provides links to benefit carriers • Website provides Summary Plan Description • Website provides Downloadable Forms • And lots of useful benefits information

  14. PSC-CUNY Welfare Fund - Google it

  15. We are here for Assistance & Advocacy PSCCUNYWF.org(212) 354-5230 61 Broadway 15th Floor NY,NY 10006

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