New Catastrophe Major Medical Plan

Updated: May 25, 2017
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OPEN ENROLLMENT THROUGH JUNE 15

A message from Sharon Persinger, PSC Treasurer
Dear Members:

I am writing to make sure you are aware of a new opportunity, available through the union, to enroll in a Catastrophe Major Medical Plan with no restrictions based on preexisting medical conditions. The 45-day enrollment period ends on June 15. This may be a one-time opportunity. I urge you to consider seriously whether this additional insurance to cover medical emergencies, available through our statewide affiliate NYSUT, is right for you.

Your health insurance and prescription drug plans, provided through benefits we have won as a union, are comprehensive and among the best of any public employees'. But they sometimes do not cover all expenses. Medicare, too, is limited in its coverage. Catastrophe major medical insurance is supplemental coverage, designed to cover high medical expenses not covered by your current health insurance. The Catastrophe Major Medical Insurance Trust administered through NYSUT (CMM) covers eligible expenses after the deductible for your existing health insurance has been met. The CMM plan will help to pay for expenses such as specialists who are out of network, expensive specialty drugs, and eligible home health care expenses. Younger members and those with dependents, as well as those approaching retirement, should seriously consider purchasing the new CMM plan.

During the open enrollment period, from May 1 to June 15, new participants may purchase catastrophic coverage for themselves and their eligible dependents. Enrollment is open to NYSUT members who are in current employment, who live in New York State and who have the required underlying medical and prescription drug coverage. (CUNY employees represented by the PSC are members of NYSUT.) Coverage will begin on January 1, 2018. Check here to make certain that you are eligible.

Annual premiums for the plan depend on the age of the participant and whether the coverage is for an individual or for a family. As an example, an individual member under the age of 40 would pay $83 annually. For a family, including spouse and children, with the main participant in their 50s, the annual premium would be around $635.

The PSC also negotiated aggressively to ensure that adjuncts who meet the eligibility requirements will be able to participate in the plan.

New enrollment in the CMM plan that was previously offered through NYSUT closed in the summer of 2011 because insurance companies withdrew from the market after the passage of the Affordable Care Act. The NYSUT CMM plan is self-funded and uses the collective power of its large membership to offer a benefit that for-profit insurance companies are no longer willing to provide. If you currently participate in the NYSUT CMM plan and want to add dependents, now is the time to enroll them.

The PSC-CUNY Welfare Fund also offered its own CMM plan until the insurance companies withdrew; that plan is no longer able to open enrollment for new participants. Members who remain in the PSC-CUNY Welfare Fund CMM plan, which provides superior benefits, should continue their current coverage.

As the union that negotiates for your health insurance through the City of New York and your supplemental health benefits through the Welfare Fund, the PSC continues to work to create opportunities for our members to receive good health benefits. We believe the NYSUT CMM plan is a very good option for many of our members.

As with any insurance plan, people considering enrollment should read carefully all the materials about the plan before making a decision. You may also contact the CMM plan administrator, Mercer Consumer, toll-free at 888-386-9788. Click here for enrollment forms and a plan description.

Applications must be postmarked by June 15, so don't delay!

Wishing you good health,
Sharon Persinger
Treasurer, PSC/CUNY
Trustee, PSC-CUNY welfare Fund