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 communications@psccunywf.org ➢ Phone (212) 354-5230 ➢ Website, psccunywf.org

➢Links & contacts to Benefit Vendors ➢Clear, concise benefit descriptions ➢Applications & Claim Forms ➢Practical, Useful Benefits Information

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