Extended Medical Benefit through PSC-CUNY Welfare Fund

March 2012

Did you know that if you are enrolled in the GHI-CBP  health benefits plan, you  have an additional level of medical cost protection through the PSC-CUNY Welfare Fund Extended Medical benefit?  This benefit is designed to provide a buffer against large medical expenses associated with a serious or long-term illness that is not met by the basic employer-provided insurance.  In addition, it provides better coverage for an out-of-network provider use of medical services.

Expenses are considered after an annual deductible has been met.  The amount of the deductible is determined by whether or not the participant has elected the GHI-CBP optional rider.  How much is the deductible?  If the participant has elected the rider, the deductible is $1,000 per person per year, with a maximum of $2,000 per family.  If the participant has not elected the rider, the deductible is $4,000 per person per year, with a maximum of $8,000 per family.

After the deductible has been met, the Welfare Fund Extended Medical plan will pay 60% of the difference between the amount reimbursed and the “reasonable and customary” charges.  “Reasonable and Customary” charges are determined by a schedule maintained by the carrier and the Fund.  For more information, please rsee the Summary Plan of All  Welfare Fund Benefits for F/T Active Members.