CUNY PSC EMPLOYEE BENEFITS HANDBOOK [1] BASIC HEALTH PLANS (Hospitalization & Major Medical) Eligibility Eligible Dependents Effective Dates of Coverage Enrollment Basic Health Plans Health Plan Provisions To Select a Health Plan Medical Spending Conversion The Premium Conversion Program The Health Benefits Buy-Out Waiver Program [2] PSC-CUNY WELFARE FUND BENEFITS Prescription Drug Plan Dental Plan Optical Plan Hearing Aid Benefit Group Life & Accidental Death & Dismemberment Insurance Eligibility Enrollment Effective Date Living Choices Conversion Group Total Disability Insurance Eligibility Enrollment and Effective Date Elimination Period Basic Disability Coverage Optional Disability Coverage Conversion Long Term Care Plan Eligibility Enrollment Premium Major Medical Supplements CIGNA Major Medical Supplement Eligibility Enrollment Deductible $2,000,000 Catastrophe Major Medical Insurance Plan Eligibility Deductible Enrollment Effective Date Premium [3] FLEXIBLE SPENDING ACCOUNTS Eligibility Enrollment Effective Date of Coverage Forfeiture Rules Coordination of Benefits Rules for Coordination Special Rules for Dependents of Separated or Divorced Parents [4] TERMINATION OF COVERAGE Options Available When Coverage Terminates COBRA Continuation of Benefits Eligibility Periods of Continuation Notification Responsibilities Election of COBRA Continuation [5] WORKERS' COMPENSATION [6] RETIREMENT BENEFITS The City of New York Teachers' Retirement System Type of Plan Vesting Retirement Eligibility Contribution Rates Retirement Allowance Tax-Deferred Annuity Disability Benefits Death Benefit Portability Loans Retiree Health Benefits   The Optional Retirement Program Type of Plan Vesting Retirement Age Contribution Rates Retirement Allowance Tax-Deferred Annuity Disability Benefits Death Benefit Portability Loans Alternate Funding Vehicles Retiree Health Benefits         [1] BASIC HEALTH PLANS (HOSPITALIZATION AND MAJOR MEDICAL) (Top) Eligibility (Top) As a member of the Instructional Staff of The City University of New York, you are eligible for health coverage under the City of New York's Health Benefits Program ((NYCHBP), and benefits provided by the Professional Staff Congress/CUNY (PSC-CUNY) Welfare Fund.   Eligible Dependents (Top) You may also enroll your dependents in the NYCHBP The following dependents are eligible for enrollment: a. Your legal spouse. (An ex-spouse is not eligible for     coverage under the NYCHBP regardless of the provisions     of any legal settlement). b. A domestic partner, defined as a person, eighteen years    of age or older, who is not married or related by blood to    you in a manner that would bar marriage in the State of    New York, who has a close and committed personal relationship    with you, lives with you and has been living with    you on a continuous basis, and who, together with you, has    registered as your domestic partner and has not terminated    the domestic partnership. c. Unmarried children under age 19. The term "children"    for purposes of this and the following source of definitions,    includes: natural children; children for whom a court has    accepted a consent to adopt and for the support of whom    you have entered into an agreement; children for whom a    court of law has made you legally responsible for support    and maintenance; and children who live with you in a regular    parent/child relationship and are supported by you. d. Unmarried dependent children age 19 to 23 who are     full-time students. e. Unmarried children who cannot support themselves     because of mental illness, developmental disability,     mental retardation, or physical handicap, if the disability     occurred before the age at which coverage would     otherwise terminate, and the dependent was covered     by the NYCHBP at that time.   Effective Dates of Coverage (Top) Coverage begins on your appointment date, provided your Application (Form ERB95) has been received by your College Personnel Office within 31 days of that date. Coverage for eligible dependents listed on your Form ERB95 will begin on the date that you become covered. Dependents acquired alter you submit your Form ERB95 as a result of marriage, domestic partnership, birth or adoption will be covered from the date of marriage, domestic partnership, birth or adoption, provided that you submit the required notification and documentation within 31 days of the event.   Enrollment (Top) To enroll, you must obtain an Employee Health Benefits Application (Form ERB95) at your College Personnel Office. The form must be filed within 31 days of your appointment date. If you do not file the form within 31 days of your appointment date, the start of your coverage will be delayed and you may be subject to loss of benefits. You are required to provide acceptable documentation to support the eligibility status of all persons to be covered by the NYCHBP, which may include a birth certificate, marriage certificate, divorce papers, etc. You cannot be covered by two health contracts for which the City pays or to which the City contributes.   BASIC HEALTH PLANS (Top)     As an eligible participant of the NYCHBP, you may choose from several health plans. These plans provide basic coverage which may or may not require an additional premium from you. You may obtain additional benefits by paying an additional premium through payroll deductions on a pre- tax basis. The health plans available to you are: 1. BLUECHOICE POS 2. Choice Care (Available in Queens, Nassau and Suffolk counties only) 3. CIGNA HealthCare 4. GHI CBP/EBCBS 5. GHI TYPE C/EBCBS (For current members only) 6. HlP - HMO 7. HIP CHOICE PLUS 8. PHYSICIANS HEALTH SERVICES (Available in the Bronx, Brooklyn, Queens, Manhattan,Staten Island, Nassau, Suffolk, Westchester, Putnam, Rockland, Dutchess and Orange Counties and the State of Connecticut) 9. SANUS PLUS 10. US HEALTHCARE QPOS 11. US HEALTHCARE HMO 12. WELLCARE OF NY (Available in the counties of Albany, Brooklyn, Broome,Bronx, Columbia, Delaware, Dutchess, Fulton, Greene, Manhattan, Montgomery, Orange, Otsego, Putnam,Queens, Rensselaer, Rockland, Saratoga, Schenectady,Schoharie, Sullivan, Ulster, Warren, Washington, and Westchester in New York.)   HEALTH PLAN PROVISIONS (Top)     Most, but not all, of the health plans available to CUNY employees provide the following care, with various limitations according to the particular plan: Outpatient Care Physicians' Office Visits Surgery - Physician's Office or Hospital Outpatient Laboratory and X-Ray Services Hospital Care Semi-Private Room and Board Physicians' and Surgeons' Services General Nursing Care Drugs and Medication Diagnostic Services (Lab Work, X-Rays) Intensive and Coronary Care Units Use of Operating and Recovery Room Anesthesia Emergency Care Ambulance Service Doctors' Offices Hospital Emergency Room Preventive Care Routine Physical Check-Up Routine Pediatric (Well-Baby) Care Immunizations Routine Hearing Exams/Vision Care Mental Health and Chemical Dependency Care Outpatient Inpatient Maternity Care In Physicians' Offices: Prenatal and postnatal visits In the Hospital: Physicians' Services - Mother and newborn Newborn Nursery Services Mother's Hospital Services Home Health Care Services Home Care Services Hospice Care Skilled Nursing Facility Rehabilitation Physical Speech Pharmacy Services Organ Transplants   TO SELECT A HEALTH PLAN (Top) To select a health plan that best meets one's needs, one should consider the following factors: 1.Coverage: Some plans provide preventive services, others do not, some cover routine care, others do not. 2.Choice of Doctor: Some plans provide partial reimbursement when non-participating providers are used. Other plans only pay for or allow the use of participating providers. 3.Convenience of Access: Certain plans may have participating providers or centers that are more convenient to either your home or workplace. One should consider the location of physicians' offices and hospital affiliations before selecting a health plan. 4.Cost: Some plans require payroll deductions for basic coverage. The cost of Optional Riders also differs. Some plans require a co-payment for each routine doctor visit. Some plans require the payment of a yearly deductible and coinsurance before the plans will reimburse you for the use of non-participating providers. If a plan does not cover certain types of services that one expects to use, one must also consider the out-of-pocket cost of these services. To obtain further information on benefits, participating doctors, office locations, costs, please refer to the New York City Health Benefits Program Description.   MEDICAL SPENDING CONVERSION (MSC) (Top) MSC is comprised of two programs: A. The Premium Conversion Program and B. The Health Benefits Buy-Out Waiver Program. A. Premium Conversion Program (Top) The Premium Conversion Program allows employees who make payments for basic and/or optional benefits to have the deductions taken from their paychecks on a pre-tax basis and thereby increase their take-home pay. Employees who have no payroll deductions for health benefits are not considered participants in the Premium Conversion Program. A newly hired employee who does not want to participate in the Premium Conversion Program may decline participation by obtaining an MSC Form from the College Benefits Office and submitting it together with the Health Benefits Application (Form ERB95). B. Health Benefits Buy-Out Waiver Program (Top) The Health Benefits Buy-Out Waiver Program allows employees eligible to receive benefits through the NYCHBP to waive their health benefits and receive a cash incentive payment, if they are covered under a spouse's or domestic partner's health plan or through another employer. The annual incentive payment of $500 for individual coverage, or $1000 for family coverage, is taxable to the employee. [2] PSC-CUNY WELFARE FUND BENEFITS (Top) PRESCRIPTION DRUG PLAN  (Top) 1. GHI/CBP a. NPA Generic Reimbursement Plan Card and    Central Fill Mail Order Plan in place of GHI drug    rider. Co-payment: $5 or 20%, whichever is    greater. 2. HIP/HMO and HIP CHOICE a. HIP drug rider b. Additional mental health benefits 3. All Other Health Plans a. GHI, Blue Choice, Physicians Health Services and     Choice Care have the drug rider through NPA. b. All other health plans provide the drug rider.   DENTAL PLAN  (Top) 1 Dental Reimbursement Plan    $100/individual and $200/family deductible for non-    participating provider.    $1750 lifetime maximum for Orthodontics    Reimbursement as per schedule of fees 2. Self - Insured Dental Services (SIDS)    No deductible    $1750 lifetime maximum for Orthodontics    Co-payment for certain procedures   OPTICAL PLAN  (Top) Benefit is available once every 24 months 1. Direct Reimbursement Plan     $100 maximum reimbursement for prescription     glasses purchased through a non-participating     provider 2. Davis Vision     Plan includes eye examination and prescription     glasses     Options available at participant's expense,     co-payment of $25 for contact lenses 3. General Vision Services (GVS)     Plan includes eye examination and prescription     glasses     Options available at participant's expense   HEARING AID BENEFIT  (Top) Benefit is available once every 36 months 1. Direct Reimbursement     $500 maximum 2. CUNY participating outlets (Brooklyn & Queens College) 3. General Vision Services (GVS)   GROUP LIFE & ACCIDENTAL DEATH DISMEMBERMENT INSURANCE     (FOR EMPLOYEES ONLY)  (Top) Eligibility  (Top) All actively-at-work, full-time employees of CUNY who are eligible for PSC-CUNY Welfare Fund benefits are eligible for Group Life & Accidental Death & Dismemberment Insurance through TIAA. 1. Basic Group Life The amount of coverage is determined by your age as of the March 31st preceding enrollment. The amount of insurance vanes according to your age, with coverage decreasing as your age is increasing. The maximum coverage is $50,000 for age 40 or less and the minimum coverage is $5,000 for age 65 and over. The full cost of the coverage is paid by the PSC-CUNY Welfare Fund and includes an equal amount of Accidental Death and Dismemberment (AD&D) insurance. 2. Optional Group Life You can increase your insurance coverage by choosing additional amounts of life insurance and paying low group life rates through payroll deductions. The options available are $25,000, $50,000, $75,000 and $100,000. The increased coverage also provides an equal amount of Accidental Death and Dismemberment insurance. Enrollment  (Top) If you enroll before, on, or within 60 days of your date of hire, no medical evidence of good health will be required. After that, you must submit written evidence on the Employee Statement of Health Form. Effective Date  (Top) If you elect additional coverage within the 60 day enrollment period, coverage goes into effect on the date you elect the coverage. If you elect additional coverage after the 60 day enrollment period, coverage will go into effect on the date TIAA approves the proof of good health. LIVING CHOICES: An accelerated death benefit from TIAA is a provision of this Group Life Insurance. This allows an employee who is terminally ill (life expectancy of 12 months or less) the opportunity to collect all or part of his/her life insurance at a time when he/she needs it most. It is paid in a lump sum, without fees, in amounts up to 100% of the policy. Conversion  (Top) The life insurance coverage may be converted to an individual policy at termination of employment or retirement.   GROUP TOTAL DISABILITY INSURANCE (FOR EMPLOYEES ONLY)  (Top) Long-term disability is defined as the employees inability to perform any occupation for which he or she is reasonably suited by education, training or experience because of sickness, bodily injury or pregnancy. The employee must be under the regular care of a Physician, other than himself or herself. Eligibility  (Top) All Actively-at-work, full-time permanent employees of CUNY, who are eligible for PSC-CUNY Welfare Fund benefits, are eligible for a basic disability coverage, at no cost to the employee, after completing one year of service. The employee may also elect to pay for additional disability coverage. Enrollment and Effective Date  (Top) An eligible employee must be actively-at-work on the date of enrollment eligibility. If the employee elects coverage within the 60-day enrollment period, coverage goes into effect on the date the employee elects the coverage. If the employee elects coverage after the 60-day enrollment period, coverage will go into effect on the date TIAA approves the proof of good health. Elimination Period  (Top) The employee must be on disability for a continuous period of six (6) months before the basic long-term disability program pays benefits. Note: The monthly income benefit provided by this plan subtracts any employer-provided benefits from your monthly disability check, such as Social Security, Workers' Compensation, sick leave or other retirement or disability benefits, and may be subject to Federal, State and local taxes. 1. Basic Disability Coverage (Top) The basic disability coverage pays 50% of the pre-disability salary with a minimum of $1,250/month and a maximum of $2,500/month before offsets. This basic monthly income benefit begins on the first of the month following six consecutive months of total disability. If one continues to receive sick leave payments which equal the monthly wage past six consecutive months of total disability, benefits will begin on the first day of the month after the month in which the last sick leave payment equal to the monthly wage base is paid. Benefits continue to the earlier of five years or age 65 if one becomes disabled at age 60 or less; four-and-a-half years if one becomes disabled between age 60 and 65; to age 70 if one is 65 but less than 68 ½; and one Year if one is 68 1/2 or older. 2. Optional Disability Coverage (Top) The basic disability coverage is provided for a maxi- mum of five years. If one needs further protection, one may elect to pay an additional premium through payroll deductions for the optional Long-Term Disability insurance which provides the following: a. Increased Monthly Benefit     Benefits increase from 50% of the monthly salary     to 60%. The minimum benefit is $1,500 and the     maximum is $5,000 before offsets. b .The Annuity Premium Benefit     Contributions to your TIAA-CREF pension accumulation  equal     to 10% of your monthly pre-disability salary - continue during disability.     If you are a member of NYCERS or NYCTRS, a     TIAA-CREF retirement fund is set up for you.     This benefit is in addition to the monthly income     cash benefit. c. A Longer Benefit Payment Period    Benefits are extended to age 65. If disability    occurs after age 60, the duration of benefits will    continue as under the Basic plan. d. Minimum Benefit Payment    The optional plan offers a minimum TIAA benefit    of $100 a month, even if your disability income    from other sources equals or exceeds your    monthly calculated income benefit. Restrictions - Optional Coverage Only If you become disabled during your first year of coverage due to a pre-existing condition, the disability is not covered by the Plan. After your insurance has been in effect for a full year, you are covered for any disability, including one resulting from a pre-existing condition. Conversion  (Top) The Total Disability Insurance terminates at termination of your employment or at your retirement.   LONG TERM CARE PLAN (LTC)  (Top) This plan provides services ranging from nursing home care to custodial care at home, including help with daily activities such as eating and dressing, to professional attention, such as skilled nursing care. It also includes services offered through adult day health care programs and other community agencies. Long Term Care provides benefits when you are unable to care for yourself because of a chronic illness, severe physical impairment or disease that lasts a long time, the normal aging process, or because of a cognitive impairment, such as Alzheimer's disease or senile dementia, which requires constant supervision. Eligibility  (Top) You may enroll for the LTC plan upon eligibility and while serving in an eligible title. Your spouse or domestic partner, parents and parents-in-law may also be covered whether or not you enroll. Enrollment  (Top) In order to qualify for coverage, each applicant must complete a medical questionnaire. You may enroll in one of the following contributory plans: 1. CIGNA Group Long-Term Care Insurance Program     (offered by the City of New York) 2. John Hancock Mutual Life Insurance Company     (offered by The PSC/CUNY Welfare Fund) 3. New York State United Teachers' Long Term Care Program 4 TIAA-CREF Premium  (Top) The premium is determined by the age at initial enrollment and may be paid through payroll deduction.   MAJOR MEDICAL SUPPLEMENTS (Top)  1. CIGNA Major Medical Supplement to GHVCBP (Top)    Coverage The CIGNA Major Medical Supplement is designed to provide additional protection against the extraordinary cost of a serious or long-term illness, not covered by your GHI/CBP allowances. Eligibility  (Top) You and your dependents are eligible for this coverage if you are: a) an active full-time member of the City University     instructional staff and b) Covered by the GHI-CBP Plan. Enrollment  (Top) If eligible, you and your dependents will automatically be enrolled in the CIGNA Major Medical coverage. Deductible  (Top) The deductible is $1,000 for an individual plan and $2,000 for a family plan for those who purchase the Optional Rider through GHI; $2,000 for an individual plan and $4,000 for a family plan for those who do not purchase the Optional Rider. Benefits will be paid for up to 80% of the remaining covered expenses. Once the total out-of-pocket expenses reach $3,000 for an individual or $4,000 for a family, benefits will be paid for up to 100% of the remaining covered expenses. 2. $2,000,000 Catastrophe Major Medical Insurance Plan (Wohler's Plan) (Top) The Catastrophe Major Medical Insurance Plan has been designed to supplement your basic policy and help pick up eligible expenses not covered by the various NYCHBP, any other major medical and hospitalization plans. These plans may provide adequate health insurance protection, but may limit benefits on a yearly basis and may limit benefits again as to covered charges. Eligibility (Top) You, your spouse or domestic partner, and dependent children from birth to 21 years of age (27 if attending school full-time) are eligible, provided you and your eligible dependents are covered under a basic health plan. Deductible (Top) There is a $10,000 deductible (or the amount paid by your basic health insurance if higher). When insured, usual and customary eligible expenses count toward your deductible in full. Even those eligible expenses paid for by your basic health insurance policy as well as those paid out of your own pocket count toward meeting your deductible. Enrollment (Top) To enroll yourself and your dependents, complete the application form, and return it to Albert H. Wohlers &Co. Effective Date (Top) As long as each person applying meets eligibility requirements, pays the premium, and has not during the five (5) years immediately prior to completing the application, been treated for, or diagnosed as having, heart disease, kidney disease, internal cancer, any immune disorder, AIDS or AIDS- Related Complex (ARC), diabetes, neurological disease, mental or nervous dysfunction, alcohol or drug dependency, coverage will be effective the 15th of the month following receipt and acceptance of the written application and applicable premium, through payroll deduction, or direct payment. Premium (Top) The premium for this plan is based upon your age at enrollment and may be paid through payroll deductions.   [3] FLEXIBLE SPENDING ACCOUNTS (Top) Flexible Spending Accounts are available for two types of expenses - health and dependent care which are funded through pre-tax payroll deductions, thereby reducing your taxable income. The Health Care Flexible Spending Account (HCFSA) help you pay for health-related expenses not paid by your health, dental or vision insurance. Dependent Care Assistance Program (DeCAP) Spending Account provides the opportunity for you to use tax-free dollars to pay for the expenses to care for your children or other dependents while you and your spouse work (or go to school full-time). Eligibility (Top) Employees eligible to participate in the HCFSA and DeCAP programs are those employees eligible for health coverage under the NYCHBP.   Enrollment (Top) To participate in either or both spending account programs, you must complete and return an Enrollment/Change Form.   Effective Date of Coverage (Top) The period of coverage for these spending account pro- grams is the tax or calendar year. For the Plan Year, the period of coverage is from January 1st through December 31st. Newly eligible employees may participate as soon as they become eligible for health benefits. To participate, newly eligible employees must submit an Enrollment/Change Form within thirty (30) days of becoming eligible for these spending account programs. Contributions will be prorated over the remaining pay periods. Enrollment is not automatic from year to year. You must re-enroll each year during the annual enrollment period. Elections will be effective January 1st, or the date of your first deduction if you become eligible after the beginning of the Plan Year.   Forfeiture Rules (Top) Federal regulations require that you use the entire amount in each of your accounts by the end of each Plan Year (December 31st). You have until February 28th (for HCFSA) and January 31st (for DeCAP) of the next year to submit any claims incurred during the prior Plan Year in which you were a participant. If you do not use the entire amount you allocate to each of your accounts, you forfeit the unused balance. This is often referred to as the Use It or Lose It rule. Note: You should also be aware that if you participate in both spending account programs, the amount you allocate to one account cannot be transferred to the other. COORDINATION OF BENEFITS (COB) (Top) You may be covered by two or more group health benefit plans, which may provide similar benefits. Should you have services covered by more than one plan, your plan through the NYCEBP will coordinate benefit payments with the other plan. One plan will pay its full benefit as a primary insurer, and the other plan will pay secondary benefits This prevents duplicate payments and overpayments. In no event shall payments exceed 100% of a charge. The NYCEBP follows certain rules which have been established to determine which plan is primary; these rules apply whether or not you make a claim under both plans. Rules for Coordination (Top) The rules for determining primary and secondary benefits are as follows: 1. The plan covering you as an employee is primary     before a plan covering you as a dependent. 2. When two plans cover the same child as a dependent,     the child's coverage will be as follows:    -  The plan of the parent whose birthday falls earlier       in the year provides primary coverage.    -  If both parents have the same birthday, the plan       which has been in effect the longest is primary.    -  If the other plan has a gender rule (stating that       the plan covering a dependent of a male employee       is primary before a plan covering a dependent       of a female employee), the rule of the other plan       will determine which plan will cover the child. 3. If no other criteria apply, the plan covering you the    longest is primary. However, the plan covering you as    a laid-off or retired employee, or as a dependent of    such a person, is secondary, and the plan covering    you as an active employee, or as a dependent of such    a person, is primary, as long as the other plan has a    COB provision similar to this one. Special Rules for Dependents of Separated or Divorced Parents (Top) If two or more plans cover a dependent child of divorced or separated parents, benefits are to be determined in the following order: 1. The plan of the parent who has custody of the child     is primary. 2. If the parent with custody of a dependent child     remarries, that parent's plan is primary. The step-parents     plan is secondary and the plan covering the parent     without custody is tertiary (third). 3. If the specific decree of the court states one parent is     responsible for the health care of the child, that     parent's plan is primary. You must provide the appropriate     plan with a copy of the portion of the court     order showing responsibility for health care expenses     of the child. [4] TERMINATION OF COVERAGE (Top) Coverage terminates: - for an employee and covered dependents, when the   employee stops receiving a paycheck, except when   the employee is eligible for: a) Special Leave of Absence Coverage (SLOAC) as a     result of temporary disability or illness; or b) Family and Medical Leave Act (FMLA) which     entitles an eligible employee to twelve (12) weeks     of family leave in a 12-month period to care for a     dependent child, a covered family member, a     domestic partner, and for the serious illness of the     employee. - for a spouse, when divorced from an employee or   retiree. - for a domestic partner, when partnership   terminates . - for a child, upon marriage or reaching an ineligible   age, except for unmarried dependent full-time students   who are covered on most plans up to age 23   or 25. - for all dependents, unless otherwise eligible, when   the employee or retiree dies. Options Available When Coverage Terminates (Top) COBRA Continuation of Benefits (Top) The Federal Consolidated Omnibus Budget Reconciliation Act of 1985 requires that the City offer employees, retirees and their families the opportunity to continue group health and/or welfare fund coverage in certain instances where the coverage would otherwise terminate. The monthly premium will be 102% of the group rate (or 150% of the group rate for the l9th through 29th months in cases of total disability). All group health benefits, including Optional Riders, are available. The maximum period of coverage is 18, 29, or 36 months depending on the reason for continuation. Eligibility (Top) Employees Not Eligible for Medicare Employees are eligible for continuation under COBRA if their health and welfare fund coverages are terminated due to a reduction in hours of employment or termination of employment (for reasons other than gross misconduct). Spouses/Domestic Partners Not Eligible for Medicare Spouses/Domestic Partners of employees or retirees have the right to choose continuation of coverage if they lose coverage for any of the following reasons: l. death of the employee or retiree; 2.termination of the employee's employment (for reasons other than gross misconduct); 3. loss of health coverage due to a reduction in employee's hours of employment; 4. divorce from the employee or retiree; 5. termination of domestic partnership with the employee or retiree; 6. retirement of employee, not eligible for retiree health insurance. Dependent Children Not Eligible for Medicare Dependent children of employees or retirees have the right to continue coverage if coverage is lost for any of the following reasons: 1. death of a covered parent; 2. the termination of a covered parent's employment (for reasons other than gross misconduct); 3. loss of health coverage due to the covered parent's     reduction in hours of employment; 4. the dependent ceases to be a "dependent child" under the terms of the     NYCEBP; or 5. retirement of the covered parent. Note: Individuals covered under another group plan are not          eligible for COBRA continuation of benefits unless          the other group plan contains a pre-existing condition          exclusion. However, these individuals may be          able to purchase certain welfare fund benefits. Periods of Continuation (Top) Continuation of coverage for the former employee, retiree, family, or individual dependent as a result of termination of employment (for reasons other than gross misconduct), reduction of work schedule, or loss of welfare fund benefits due to retirement is available for a maximum period of 18 months. This period will be measured from the loss of coverage. If the employee is totally disabled on the date of termination from employment or reduction of hours, continuation of coverage for the employee and eligible dependents may be extended from 18 to 29 months. The monthly premium for the l9th through 29th month will be 150% of the group rate. To qualify for 29 months of COBRA continuation of coverage, Social Security must determine that the employee is totally disabled. If Social Security later determines that the individual is no longer totally disabled, COBRA continuation of coverage may terminate before the end of the 29th month. Continuation of coverage for a spouse/domestic partner or dependents as a result of the death, divorce, domestic partnership termination, or loss of coverage due to Medicare- eligibility of the contract holder, or loss of dependent child status, is available for a maximum of 36 months. Continuation of coverage can never exceed 36 months in total, regardless of the number of events which relate to a loss in coverage. Coverage during the continuation period will terminate if the enrolled fails to make timely premium payments or becomes enrolled in another group health plan (unless the new plan contains a pre-existing condition exclusion). Notification Responsibilities (Top) Under the law, the employee or family member has the responsibility of notifying the College payroll or personnel office and the applicable welfare fund within 60 days of the death, divorce, domestic partnership termination, or change of address of an employee, or of a child's losing dependent status. Retirees and/or family members must notify the NYCEBP and the applicable welfare fund within 60 days in the case of death of the retiree or the occurrence of any of the events mentioned above. Employees who are totally disabled (as determined by Social Security) on the date of termination of employment or reduction of hours must notify their health plan of the disability. The notice must be provided within 60 days of Social Security's determination and before the end of the 18-month continuation period. If Social Security ever determines that the individual is no longer totally disabled, the former employee must also notify the health plan of this. This notice must be provided within 30 days from Social Security's final determination. When the qualifying event (such as an employee's death, termination of employment, or reduction in hours) occurs, the employee and family will receive a COBRA information packet from the College describing continuation coverage options. Election of COBRA Continuation (Top) To elect COBRA continuation of health coverage, the eligible person must complete a COBRA - Continuation of Coverage Application Form. Employees and/or eligible family members can obtain application forms from their College Personnel Office. Retirees' eligible family members can obtain application forms by contacting the NYCEBP and the Welfare Fund. Eligible persons electing COBRA continuation coverage must do so within 60 days of the date on which they receive notification of their rights, and must pay the initial premium within 45 days of their election. Premium payments will be made on a monthly basis. Payments after the initial payment will have a 30-day grace period. [5].WORKERS' COMPENSATION (WC) (Top) If you have a job-related illness or injury, you may be entitled to WC benefits. To be eligible, you must report the illness or accident immediately, to the College Personnel Office. [6] RETIREMENT BENIFITS (Top) New York State law mandates participation in a retirement system. A new staff member has 30 days from his/her appointment date to choose a retirement program, and the choice is irrevocable. If no choice is filed within 30 days, the law mandates that the member be assigned to the City of New York Teachers' Retirement System. You may choose between the City of New York Teachers' Retirement System (TRS) or the Optional Retirement Program (ORP). If you are already a member of the NYC TRS or the NYC ERS, you may remain in that program. If you are a retiree receiving a pension from NYS or any of its political subdivisions, you may be required to obtain approval to work, but you cannot participate in a New York State or New York City retirement program. THE CITY OF NEW YORK TEACHERS RETIREMENT SYSTEM (TRS): TIER IV (Top) Type of Plan      Defined Benefit Plan: Benefits are                           based on age, final average salary                           (FAS) and years of service. Vesting              Ten (10) years Retirement        Minimum: Age 62 and 10 years of Eligibility           credited service OR age 55 with 15                           years of service at an actuarially                           reduced rate or age 55 with 30 years                           or more of service with no reduction. Contribution      Employee pays 3% of regular compensation Rates                 on a federally tax-deferred                          basis. Employer contributes a lump-                          sum annually to its pension funds, not                          to individual accounts. The annual                          amount is determined by the actuary                          of TRS.(Top) Retirement        Less than 25 years of service: 1.67% x Allowance        FAS (average salary paid for highest                          three consecutive years) x years of service.                          25 to 30 years of service: 2% x                          FAS x years of service. Over 30 years                          of service: Additional 1.5% after 30                          years x FAS x years of service after 30. Tax-Deferred     You may participate in a tax-deferred Annuity  (TDA)  annuity program-403(b) plan, which                          allows you to set aside pre-tax dollars                          subject to a maximum exclusion                          allowance. For more information,                          please consult your College Personnel                          Office.(Top) Disability           A member of TRS is eligible to retire Benefits             for Ordinary Disability if he or she has                          10 or more years of service credit.                          Benefit schedules and formulas are                          spelled out in the laws relating to Tier                          IV Death Benefit     l/12 of last year's earned salary x years                          of service to a maximum of 36 years                          or one year's salary x years of service                          to a maximum of 3 years which is                          reduced actuarially after 61. Portability         Service credit transferable only to                          another NY public defined benefit                          retirement plan. Member contributions                          are refundable upon request, if one                          leaves prior to vesting. Loans               Available, on member contributions. Retiree Health Benefit  (Top) You are eligible for health coverage and you may enroll in the NYCEBP when you retire if you meet all of the following criteria: a. You have, at the time of retirement, at least five (5)    years of credited service as a member of a retirement    or pension system maintained by the City of New    York (this requirement does not apply if you retire    because of accidental disability); and b. You have been employed by the City immediately    prior to retirement, as a member of such system, and    have worked regularly for at least 20 hours per week;    and c. You receive a pension check from a New York City    retirement system. THE OPTIONAL RETIREMENT PROGRAM (ORP) (Top) Type of Plan     Defined Contribution Plan: Benefits                         are based on the amounts contributed                         by the employer and the employee                         and the success of the investments. Vesting             After the first twelve months of continuous                         employment, with contributions from date of                         appointments. Immediate with an open TIAA-CREF                         contract . Retirement       Minimum: None Age Contribution    New ORP participants pay 3% of Rates               salary on a federally tax-deferred basis.                        Employer pays a yearly amount equal                        to 8% of salary for first seven (7) years                        of employment and 10% thereafter. Retirement      Retirement benefits are based on your Allowance      annuity accumulations, age at retirement,                        and the income option you                        select . (Top) Tax-Deferred   You may participate in a tax-deferred Annuity          annuity program-403(b) plan, which                       allows you to set aside pre-tax dollars                       subject to a maximum exclusion                       allowance. For more information,                       please contact your College Personnel                       Office. Disability        Member may choose to retire and Benefits          begin annuity income any time.                       However, the city-provided health                       benefits may not be available to the                       member, depending on appointment                       date, years of CUNY service and other                       provisions of the Agreement between                       CUNY and PSC-CUNY. Death             Total amount in retirement and TDA Benefit           accounts.(Top) Portability      Accumulations are transferable to                       more than 3,600 educational institutions                       that have TIAA-CREF plans. Loans             Available only from the TDA account. Alternate        Available for diversification of your Funding       ORP investments. At present, the Vehicles         AFVs are Guardian and MetLife. Please (AFV)             contact your College Personnel Office                       for more information. Retiree Health Benefits     Members of the ORP who are collecting retirement benefits shall be eligible for coverage in the NYCEBP if they meet the age and years of pensionable, continuous, full-time CUNY service requirements. Please consult your College Personnel Office for your eligibility status.(Top) ____________________________________________________ THE SUMMARY OF BENEFITS IS SUBJECT TO CHANGE WITHOUT NOTICE AND THEREFORE IS PROVIDED BY THE UNIVERSITY BENEFITS OFFICE OF THE CITY UNIVERSITY OF NEW YORK SOLELY FOR INFORMATIONAL PURPOSES. EVERY EFFORT HAS BEEN MADE TO ASSURE ITS ACCURACY. THE APPLICATION OF THESE BENEFITS IS SUBJECT TO THE INTERPRETATION AND RULES OF THE BENEFIT PROVIDERS AND RETIREMENT SYSTEMS.