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The new benefits, as defined below, are available to all participants in the PSC-CUNY Welfare Fund: full-timers, part-timers, retirees and eligible dependents.
Guardian Enhanced Reimbursement Schedule
As of January 1, 2017, members and their dependents participating in the Guardian dental plan will see a substantial increase in the amount the Fund pays the dental provider (reimbursement schedule) for most dental procedures, such as crowns, dentures, child orthodontia and implants, when obtained through a Guardian- participating provider.For those who use Guardian dentists, out-of-pocket costs for many dental procedures will decrease significantly for procedures performed on or after January 1, 2017.
Guardian network dentists charge substantially less than their usual and customary fee to Guardian-participating members. As of January 1, 2017, the Fund will increase the reimbursement schedule for Guardian providers with the expectation that members who receive treatment from a Guardian dentist will have, on average, 60% to 75% of their costs covered, depending on the procedure.
The out-of-network reimbursement schedules will also be enhanced for some emergency, non-preventive procedures (e.g. fillings and root canals).
The reimbursement schedules for preventive services, such as cleaning and exams, will remain unchanged for both in- and out-of-network providers. For in-network preventive procedures, the current reimbursement schedule meets, on average, 80% of costs.
The new reimbursement schedules will take effect on January 1, 2017. Full details will be available on the Welfare Fund website. Delta Dental HMO participants will continue under the current plan terms.
Davis Vision Brochure 2017
The Fund has contracted with Davis Vision to be an exclusive network provider for glasses and contact lenses. For most prescriptions, members who use the extensive network of Davis Vision providers will be able to obtain an eye exam, frames and lenses, or contact lenses free of charge. Members who choose to use non-network providers for vision correction are eligible for a $200 direct reimbursement, which is double the current amount.
The Davis Vision network includes their own stores, called VisionWorks, and also a large number of participating in-network private practice opticians and optometrists throughout the metropolitan area and nationally. A full list of participating providers is available on the Davis Vision website. Some members may find that their current provider is already in the Davis Vision network. Retirees who live outside of New York State are already covered under a Davis Vision exclusive network plan.
The full range of Davis Premier Collection eyeglass frames and Premium Collection contact lenses will be available free of charge. Photo-sensitive lenses, premium progressive lenses, ultra anti-reflective coating, and many other enhancements will be included free of charge.
If you use an in-network vision provider and select a frame that is not in the Davis Premier Collection or contact lenses that are not in the Davis Premium Collection, you will receive a discount on the frames or contacts, plus a store credit. Full details are available on the Welfare Fund website. If you use a non-network provider, you will be eligible for a direct reimbursement once every 24 months at the new level of $200.
Vision Benefits are available to all covered members and dependents once every 24 months. Eligible dependent children under 19 years old, however, are eligible for benefits once every 12 months, but only when the off-year services are rendered by a participating Davis Vision provider.
As of January 1, 2017, the Fund will end its contract with General Vision Services. Members who wish to continue using their GVS provider will still be able to apply for the $200 out-of-network member reimbursement.
HearUSA Plan Brochure 2017
On January 1, 2017, the Welfare Fund will introduce a major improvement in its coverage of hearing aids. The Fund has contracted with HearUSA to be an exclusive network provider of hearing aids. HearUSA has a national network of 4,000 providers, including HearUSA stores and private-practice audiologists. Members and their eligible dependents are eligible for either an in-network or an out-of-network benefit once every 36 months.
To obtain service from HearUSA, members must begin by scheduling an appointment with a provider by first calling the HearUSA toll free number, (800) 442-8231. You will be given the names of three participating HearUSA practitioners in your area and the nearest HearUSA store. You may continue to request additional names of participating practitioners until you are satisfied with your choices. If you have a specific hearing aid manufacturer in mind, you may also request the names of nearby HearUSA participating practitioners who carry hearing aids from that particular manufacturer. HearUSA offers hearing aids from 11 manufacturers.
Members and Dependents are eligible for:
To learn more or to make an appointment with a HearUSA provider, you must contact HearUSA directly at (800) 442-8231, and let HearUSA know that you are a member ofPSC-CUNY Welfare Fundso they can determine your eligibility.
Read Welfare Fund Executive Officer Steve London's letter announcing the benefit enhancements here.
View the Benefits Enhancement Powerpoint Presentation
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