PSCCUNY WELFARE FUND Supplemental Health Benefits provided through

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 • 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

Adjunct Benefits Ø Prescription Rx Ø Dental Ø Vision Ø Extended Medical (w/GHI-CBP) Ø Hearing Aids Coverage is individual. Family: $190. 75/month & Enrollment in Family Basic Health is Required

Prescription Drugs l The CVS/Caremark program applies to all plan participants who have basic NYC Health Benefits Program coverage, except those who enroll in HIP- POS, CIGNA or GHI-HMO and elect the Rx drug benefit rider. l l l 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

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

CVS Prescription Drug Plan Acute Care Drugs : up to 30 -day supply Ø Ø Generic: 20%* coinsurance, $5. 00 minimum Preferred Formulary** : 20%* coinsurance, $15. 00 minimum Ø Non-preferred Formulary** : 20%* coinsurance, $30. 00 minimum * whichever is greater ** CVS/Caremark drug list is available on our website, psccunywf. org

Prescription Drugs Rx Stipend Program Some basic health insurance includes Drug Benefit Rider v v 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.

Dental Option A Guardian Dental. Guard Preferred v Preferred Provider Organization-PPO Network v Participating v v No deductible, annual or lifetime maximum payment Dental Schedule v each v v v panel, but may use any dentist dental service has a scheduled fee Participating Dentists Charge Reduced Fees Best Reimbursement is for Preventive work Child Orthodontia

Dental Option B Delta Care USA v v v 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

Extended Medical ASO PSC-CUNY Program Deductible Ø Ø 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 Ø After deductible is met, Welfare Fund Extended Medical pays 60% Ø 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

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

Hearing Aid l l l l 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

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

PSC-CUNY Welfare Fund - Google it

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