FAQs

Home 5 FAQs

Select a topic below to find answers to some of the questions we hear most often. If you don’t find an answer to a question you have, please submit it to communications@psccunywf.org.

FAQs for:

Eligibility/Paycheck or Pension Deductions

Can I switch from one insurance plan to another?

You are able to transfer insurance plans during open enrollment time, which is usually in October or November, with a January 1 effective date. However, retirees who have been retired for at least one year can take advantage of a once-in-a-lifetime provision to transfer or add an optional rider at any time. Once-in-a-lifetime transfers become effective on the first of the month following the date that the Health Benefits Application is processed.

What do my paycheck or pension deduction codes mean?

Your paycheck or pension stub may show codes for various policies and benefits you purchased from the PSC-CUNY Welfare Fund or from New York State United Teachers (NYSUT). Having trouble recalling what the codes mean? Here’s a handy guide that can help.

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Dental

How much time do I have to send in a claim for reimbursement for a dental service?

Claims must be filed within one year of treatment.

How long does it take to be reimbursed for dental benefits?

Please allow 6 to 8 weeks to receive reimbursement.

How do I replace my Guardian card?

To replace lost cards, call Guardian customer service, 800-541-7846. Your plan number is 381084.

I haven't got my Guardian card yet, but I need to see a dentist!

Go to guardiananytime.com and register with your Social Security number and Group number G-00381084. You will be able to print out a Guardian dental card.

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Prescription Drug

How long will it take to get my first mail-order fill of a new prescription?

It can take up to three weeks for the first mail-order fill. You should buy your first 30-day supply from a retail pharmacy, and then mail-order a 90-day supply.

What do I do if my medications are late?

Call the Welfare Fund (212-354-5230). We can place a two-week emergency retail fill for you at no extra cost.

If I'm out of the country and need medication, can I use my CVS/Caremark card?

No. You will have to pay for the medication out-of-pocket.

How much time do I have to send in a claim for reimbursement for a prescription drug purchase?

Claims must be filed within 90 days of service or purchase.

How long does it take to be reimbursed for prescription drug benefits?

Please allow 6 to 8 weeks to receive reimbursement.

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High-Cost Rx Program

What receipts should I save to make a claim?

Beginning January 1, save and make copies of ALL CVS retail pharmacy register receipts, CVS mail-order receipts and CVS Specialty receipts.

How can I know if I have $2,500 in eligible out-of-pocket costs?

By saving your CVS receipts you are keeping track of your annual accruing copay costs.

Can I be reimbursed for the copay costs of diabetic medicines?

Diabetic medicines are not eligible for claims because they are covered by your basic health insurance plan, not CVS.

I get injectable and/or chemotherapy drug coverage from the NYC PICA Express Scripts plan. Can I get reimbursed for those copays?

No. The plan only reimburses copay costs for prescriptions purchased through the Welfare Fund CVS Prescription Plan.

What if I have a Catastrophe Major Medical (CMM) insurance plan?

Welfare Fund members who are covered by the Welfare Fund CMM plan or the NYSUT CMM plan must first make reimbursement claims on those plans. If you are covered by either of the plans above, an Explanation of Benefits (EOB) from the insurer must be included in your High-Cost Rx Plan reimbursement claim.

My CVS copays are very high. How soon can I get reimbursed?

Reimbursement claims may be made quarterly, according to the schedule below. The Fund will look to increasing the frequency of claim submissions as we see how the first year goes.

Q1 (Jan. 1 – Mar. 31) on or after April 15th
Q2 (Jan. 1 – June 30) on or after July 15th
Q3 (Jan. 1 – Sept. 30) on or after Oct. 15th
Q4 (Jan. 1 – Dec. 31) on or after Jan. 15th

Claims will not be accepted until the 15th day following the end of the quarter. Claims will be accepted up to March 31st of the following year for claims with date of service in the prior plan year. Only one (1) claims submission per quarter will be accepted.

What if waiting for a quarterly reimbursement poses a severe financial hardship. What should I do?

Please contact the Fund and arrange for an individual counseling session. Call 212-354-5230 and ask to speak to a prescription drug coordinator.

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Vision

Do I need a card to use my Vision benefit?

Davis Vision does provide a card upon enrollment, but you don’t need a Vision Benefit card. To use your benefit at Davis Vision Access Davis Vision’s website at www.davisvision.com and use the “Find a Doctor” feature (On the Davis homepage, click on the “Members” tab; on the subsequent page, scroll down and enter Client Code 2022), or call 1.800.999.5431 for the names and addresses of the network providers nearest you.

Call the network provider of your choice and schedule an appointment. Identify yourself as a PSC-CUNY Welfare Fund member or dependent and Davis Vision member. Provide the office with your name, SS# and the name and date of birth of any covered member/dependent needing services. The provider’s office will verify your eligibility for services. You may also create a personal account by logging onto the Davis Vision website.

How much time do I have to send in a claim for reimbursement of a vision purchase?

Claims must be filed within 90 days of the purchase.

How long does it take to be reimbursed for vision benefits?

Please allow 6 to 8 weeks to receive reimbursement.

How do I get a Vision Benefit Explanation of Benefits (EOB) for my flex account?

EOBs for in-network claims are available from the DavisVision.com website. Registered members can access and print out their own EOBs. For online registration, your ID is your Social Security number. Members can also call Davis Vision at 800-999-5431.

EOBs for out-of-network claims will be issued by Davis Vision upon receipt of member’s reimbursement application, and will be sent out under separate cover from the reimbursement check.

How do I use my Vision Benefit at Davis Vision?

To use your benefit at Davis Vision Access Davis Vision’s website at www.davisvision.com and use the “Find a Doctor” feature (On the Davis homepage, click on the “Members” tab; on the subsequent page, scroll down and enter Client Code 2022), or call 1.800.999.5431 for the names and addresses of the network providers nearest you. Call the network provider of your choice and schedule an appointment. Identify yourself as a PSC-CUNY Welfare Fund member or dependent and Davis Vision member. Provide the office with your name, SS# and the name and date of birth of any covered member/dependent needing services. The provider’s office will verify your eligibility for services. You may also create a personal account by logging onto the Davis Vision website.

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Disability

When do I become eligible for disability benefits?

You become eligible for basic disability benefits if you become totally disabled after you complete one year of service.

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Extended Medical

When I enroll in Welfare Fund Benefits, will I have the extended medical benefit?

If you are enrolled in the GHI-CBP/Empire Blue Cross Blue Shield (BCBS) plan, you are automatically enrolled in the extended medical benefit at no cost to you. If you are enrolled in any other medical plan, you are not eligible for the extended medical benefit.

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Life Insurance

How much life insurance do I have as part of my supplemental benefits?

You have a $5,000 death benefit that will be paid to your beneficiary if you die while an active employee. You may have additional coverage as well, depending on when you were hired and whether you have elected optional coverage offered by the NYSUT Member Benefits Trust.

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Hearing Aid

Can I make a claim for reimbursement of a hearing aid purchase?

For out-of-network claims first contact TruHearing at 1-877-653-8867 prior to your appointment to be eligible for a maximum $500 direct reimbursement.

How can I get a hearing aid?

To make an appointment with a TruHearing provider, call 877-653-8967 and let them know that you are a member of the PSC-CUNY Welfare Fund.

You will be given the names of three participating TruHearing practitioners in your area and the nearest TruHearing store. You may continue to request additional names of participating practitioners until you are satisfied with your choices.

Review a full description of the Hearing Aid benefit.

I Obtained a Hearing Aid From HearUSA. Will the Warranty Be Honored?

Yes. If you obtained a device within the past three years, HearUSA’s three-year warranty and three-year loss and damage benefit are valid. Call HearUSA at 800-442-8231 and speak to a representative. 

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Wellness

Is it true that my benefits cover Weight Watchers?

The NYC Employee Benefits Program and the Welfare Fund are proud to announce the partnership between Weight Watchers and the City of New York. With the City’s program, employees have access to a subsidy reducing the cost of membership by more than 50% off the regular price. Benefit-eligible dependents (spouses, children 18-26) and retirees can enjoy discounted pricing. Spouses and dependents of retirees are not eligible for the discount. The dollar value of this contribution/benefit will be included as taxable income to the employee.

Review the Weight Watchers benefit.

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Long-Term Care

I got a letter saying that Hancock is changing its name to "John Hancock USA," and the company is no longer licensed in New York. How will this affect my long-term care policy? What do I need to do?

Nothing about your policy or services will change. You do not need to do anything at all.

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Adjuncts

What happens if adjuncts don’t teach one semester but start up again the following one?

You lose your coverage for the semester you don’t teach six hours, but you can re-apply for coverage (by submitting the application forms) if you resume six hours the next semester. If you do not teach for a semester in each of two out of three consecutive academic years, you will have to re-establish your eligibility by teaching six hours in the semester during which you apply for benefits, and at least one class in the previous two consecutive semesters.

Can I qualify by combining the hours I teach at different colleges?

Yes.

Can my non-teaching and teaching hours be combined to qualify me for benefits?

Yes. Contact your campus HR office for details.

Can I qualify by working at the Research Foundation?

No.

Do summer or winter semesters count for eligibility?

No.

I lost my eligibility. Where can I find insurance?

If you lose your eligibility and can’t afford COBRA, New York’s Health Insurance Marketplace is your next best bet.

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If You Take a Leave of Absence

What happens to my benefits if I take a leave of absence?

Plan participants who go on employer-approved leave with pay (such as a sabbatical) or without pay are covered for up to 24 months for the following supplemental benefits:

  • Prescription Drugs
  • Dental
  • Optical
  • Hearing Aid
  • Disability
  • Death

If you are enrolled in the Extended Medical benefit before your leave of absence begins, it will continue only if your basic GHI-CBP coverage continues. If CUNY does not provide basic health coverage for any portion of the 24-month period, you must get coverage via COBRA or other direct payment in order to qualify. Benefits are available to participants during a leave of absence to the same extent as they were prior to a leave. Benefits continue to apply to eligible dependents.

We're having a baby! How do I apply for Parental Leave?

The information you need is in the CUNY Policy on the Family & Medical Leave Act and the Paid Parental Leave Form.

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Medicare

What is IRMAA and why is it deducted from my Social Security?

Since 2007, Medicare members whose taxable income exceeds a certain threshold have been charged more than the standard Part B and Part D monthly premiums, in accordance with a surcharge schedule. The acronym for that extra charge is IRMAA, which stands for Income Related Monthly Adjustment Amount. This year the income threshold is $85,000 for individuals and $170,000 for couples filing joint tax returns.

The NYC Health Benefits Program will reimburse the amount of the Medicare Part B IRMAA increase. The reimbursement claim form and instructions are available on the Forms page. However, the IRMAA surcharge for Medicare Part D is not reimbursed.

The rules and rates for Higher-Income Medicare Beneficiaries are available on the Social Security Administration website.

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Personal/Work/Life Issues

Problems/Issues with your personal or professional life?

The CUNY Work/Life Program, Deer Oaks Employee Assistance, can help and it’s free to employees and their families. Use “CUNY” for username and password.

I need help with personal problems that are affecting my health. Is there a service I can contact?

The CUNY Work/Life Program can help you. Call the toll-free helpline: 1-866-327-2400.

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Change of Address

How do I update my address?

You can send your new address information to the Welfare Fund by email to communications@psccunywf.org. You must also inform the HR office at your campus or workplace, as well as the membership office at the PSC, 212-354-1252.

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Pensions

How do I get help with my pension?

Many of your questions must be directed to CUNY HR, the Teachers Retirement System or TIAA. Here’s a list of those questions and who to contact.

For information on the retirement process, Travia leave, retiree benefits, forms, etc., begin with the Benefits Office at your campus or workplace. CUNY holds pre-retirement information seminars throughout the year. Your benefits officer will have the dates.

If you have a Teachers’ Retirement System pension, call (888) 869-2877 and schedule an appointment at the TRS office on 55 Water Street. Visit the very useful TRS website.

If you have a TIAA retirement account, meet with the TIAA representative on your campus.

Before making an appointment with the Retirement Benefits Counselor, please answer the Pre Retirement questionnaire and email the information to Welfare Fund Retiree Benefits counselor Sandra Zaconeta.

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Retirement

How do I start the retirement process?

For information on retirement, Travia leave, forms, etc., begin with the benefits office at your campus or workplace. CUNY holds pre-retirement information seminars throughout the year. Your benefits officer will have the dates.

Many of your questions must be directed to CUNY HR, the Teachers Retirement System or TIAA. See Pre-Retirement Questions for Campus HR, TRS, & TIAA below.

For information on the retirement process, Travia leave, retiree benefits, forms, etc., begin with the Benefits Office at your campus or workplace. CUNY holds pre-retirement information seminars throughout the year. Your benefits officer will have the dates.

If you have a Teachers’ Retirement System pension, call (888) 869-2877 and schedule an appointment at the TRS office on 55 Water Street. Visit the very useful TRS website.

If you have a TIAA retirement account, meet with the TIAA representative on your campus.

Before making an appointment with the Retirement Benefits Counselor, please answer the Pre Retirement questionnaire and email the information to Welfare Fund Retiree Benefits counselor Sandra Zaconeta.

What Are My Welfare Fund Retirement Benefits?

Descriptions of the Retiree Benefits can be found on the Retirees page.

Pre-Retirement Questions for Campus HR, TRS, & TIAA

As you prepare to retire, you may have many questions! Questions on the topics below should be directed to your CUNY Campus HR/Benefits officer:

  • What system do I belong to (TRS or TIAA or NYCERS) or did I ever belong?
  • How much vacation time do I have?
  • How much sick leave (TRAVIA leave) do I have?
  • When can I begin or end TRAVIA leave?
  • Questions about my NYC health insurance options when I retire
  • Questions about the premiums for the NYC health plan I pick for retirement
  • Questions if all of my forms are in good order / were they handed in / do we have them at PSC CUNY WF for when I retire (NYC Health Benefits Application / PSC CUNY Welfare Fund Retiree Enrollment Form / SilverScript)

Questions on the topics below should be directed to TRS or TIAA:

  • Loans (how to apply, status)
  • Investments (what you have, how to make changes, what is the performance)
  • Retirement disability (how to apply)
  • How to change communication preferences (access to account online or delivery of quarterly statements)
  • Address changes / Beneficiary changes
  • Status of pension checks or income payments
  • How to request a change of Advisor (TIAA members only)
  • Status of service update / cost letters for buyback (TRS members only)

The Fund’s Retirement Benefits Counselor will meet with members only if you are age 55 or older and you are within five years of retirement.

  • Retirement Meeting (if you will retire within the year)
  • Pre-Retirement Meeting (if you will retire in 2-5 years)
  • Most TIAA members will have a Phone Meeting
  • Most TRS members will have an office meeting

TRS members meet with the Retirement Benefits Counselor to discuss:

  • How to plan for TRAVIA leave
  • Eligibility and benefits associated with NYC health insurance for Non-Medicare and Medicare eligible retirees
  • Medicare Part B reimbursements / IRMAA reimbursements
  • TRS pre-retirement calculations and options for ALL TIERS. Calculations for TIER III, TIER IV & TIER VI can be done online at www.trsnyc.org

TRS Members go to the TRS Walk-In Center only for these issues:

  • To file their TRS Retirement Paperwork to begin receiving pension checks
  • To pay for a buyback or membership deficit (you should have your Cost Letter)

TIAA members CALL the Retirement Benefits Counselor to discuss:

  • How to plan for TRAVIA leave
  • Eligibility and benefits associated with NYC health insurance for Non-Medicare and Medicare eligible retirees
  • Medicare Part B reimbursements / IRMAA reimbursements
  • Lifetime Income Annuity for NYC Health Benefit Program in retirement
  • TIAA Advisors / Consultants prepare retirement plans and discuss payment options with their members

Once you are retired your questions about your Medicare part B or IRMAA reimbursements should be referred to the NYC Health Benefits Program

TIAA Members call (212) 306-7251
TRS Members call (212) 513-0470

TRS NYC
(888) 869-2877
www.trsnyc.org
Walk-In Center for Members
55 Water Street
New York, NY 10041

TIAA
(800) 842-2776
www.tiaa.org
Local Office (Walk-In & Appointments)
750 Third Avenue
New York, NY 10017

PSC-CUNY Welfare Fund
Sandra Zaconeta
Retirement Benefits Counselor
61 Broadway, 15th Floor
New York, NY 10006
Phone 212-354-5230, Ext. 1317
Fax 212-354-5363
szaconeta@psccunywf.org

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