PSC-CUNY Welfare Fund Benefits: Nov. 1 – Nov. 30

October 2009

The 2009 Open Enrollment/Transfer Period for PSC-CUNY Welfare Fund Benefits is November 1 – November 30. During this time, Fund participants and benefits-eligible employees can change their dental coverage provider and enroll in the optional long-term disability plan.

All forms must be submitted by Monday, November 30, 2009.

All changes made during this period will become effective January 14, 2010.

Dental Benefit
To change your dental coverage to DeltaCare USA from Guardian, click the following link.
Enrollment Form for DeltaCare USA DMO Plan

You must include the name of your dentist on the enrollment application. You can get this information from the DeltaCare website at The “Find a Dentist” box is at the lower right-hand corner of the page. The plan name is DeltaCare USA and group number is 5864-0001.

To change your dental coverage to Guardian from DeltaCare USA, click the following link.
Transfer-out Form from DeltaCare USA DMO Plan to Guardian Dental Plan

Optional Long-Term Disability Benefit
To enroll in the optional long-term disability plan with The Standard, select and complete the enrollment and medical history questionnaire forms.
Standard Enrollment Form

Standard Medical Questionnaire