Benefits
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- Summary of Benefits
- How to Enroll in a Tax Deferred Annuity (TDA)
- Tax Deferred Annuity (TDA) Change Forms
- Medical/Dental/Optical/FMLA Forms
- Health Insurance/Buy Out Waiver/Flexible Spending Account Information
- Tuition Waiver Information
- Important Phone Numbers
- Domestic Partner Information Booklet
- Benefit Information and Forms
- TransitBenefit
- Worker's Compensation
Summary of Benefits
- Full Time Teaching and Non-Teaching Instructional Staff Benefits Booklet
- Executive Compensation Plan (ECP) Benefits Booklet
- Summary for Full Time Faculty Members
- Summary for Higher Education Officers Series (HEO)
- Summary for Executive Compensation Plan (ECP) Members
- Summary for Full Time Classified Staff
- Summary for Adjunct Staff Members
- Summary for College Assistants and Tutors
How to Enroll in a Tax Deferred Annuity (TDA)
Full and Part Time Instructional Staff -Faculty, HEO's, Registrar, CLT's, Continung Education Teachers and Adjuncts
- TIAA-CREF - Please stop by Human Resources for a complete package
- HRC - Please contact James Pino - 1-800-786-1598
- Teachers Retirement System (TRS)-available to TRS members- Please call 1-888-8-NYC-TRS
Classified Staff
- Metlife - Please contact Rosa Morales :917-217-8533
Tax Deferred Annuity (TDA) Percentage Change Forms
For changes only-return completed forms to Human Resources.
- TIAA-CREF
TDA 2009 Form - Full and Part Time Instructional Staff-Faculty, HEOs, Registrar, CLT's, Continuing Education Teachers and Adjuncts
- HRC TDA 2009 Form - Full and Part Time Instructional Faculty, HEOs, Registrar,
CLT's, Continuing Education Teachers and Adjuncts
- Metlife TDA 2009 Form
- Full and Part Time Classified Staff
- Teachers Retirement System (TRS) TDA-available to TRS members- Please call 1-888-8-NYC-TRS
Medical/Dental/Optical/Drug Claim/Hearing Aid/Wellness/FMLA Forms
- GHI Health Insurance Claim Form
Return form to GHI - Extended Medical Benefit - as of 7/1/08 - Please send the completed form, GHI Explanation of Benefits and itemized bill from Doctor to the address on the top of the form
- Guardian Dental Schedule of Allowable charges - for PSC CUNY emplyees only; as of 01/01/2007
-
Guardian Dental Guard Preferred Benefit Information- for PSC CUNY emplyees only
- Guardian Dental Insurance - for PSC CUNY emplyees only PSC-CUNY Welfare Fund. For out of network providers. Please return the completed form to Guardian
- Delta Dental - for PSC CUNY emplyees only - as of 01/01/2007
- Delta Dental - Enrollment/Change form
- Claim Form for Direct Optical Reimbursement (PSC-CUNY Welfare Fund) Return form to PSC/CUNY Welfare Fund
- Drug Claims - Medco. Members of Medco either use their Drug Card at a pharmacy or use Mail Order. The most cost-effective way to buy long-term medications is to use Mail Order. Medco Mail Order Form If covered, but drugs were purchased, a Reimbursement Form is used.Medco Reimbursement Form
- Hearing Aid - Hearing Aid Reimbursement Form
- Wellness- Weight Watchers Reimbursement Form
- Family Medical Leave of Absence Information
- CUNY Family Medical Leave Policy
- Family Medical Leave of Absence Application
- Application for Child Care Leave (Full Time Teaching and Non-Teaching Instructional StaffFaculty, HEO's, Registrar and CLT's-for unpaid portion of leave)
- Loss of Dependent Status COBRA Request Form
Health Plans/Buy Out Waiver/ Flexible Spending Account Information
- Health Benefits Buy Out Waiver Application-2009
Return with health benefits enrollment application,marriage/birth certificates and proof of non City health coverage - Flexible Spending Account Information-2009
- Flexible Spending Account Enrollment Form-2009
- Health Care Flexible Spending Account (HCFSA) Program
- Employees must re-enroll each year during open enrollment
- Claim Form
- Qualifying Event Mid-Year Change Form - 2009
- Dependent Care Assistance Program (DeCAP)
- Employees must re-enroll each year during open enrollment
- Claim Form
- Qualifying Event Mid-Year Change Form -2009
Tuition Waivers
Important Phone Numbers
- Classified Staff Contact Sheet
- Full and Part Time Teaching and Non Teaching Instructional Staff (Faculty, HEO's, Registrar , CLT's and Adjuncts) Contact Sheet
Benefit Information and Forms
Full and Part Time Classified Staff
- NYCERS - Tier 4 Application Form
Return notarized with a copy of birth certificate to Human Resources - Health Benefits Buy Out Waiver Application-2009
Return with health benefits enrollment application,marriage/birth certificates and proof of non City health coverage - Metlife Long-Term Care Program - or call 1-866-414-7076
Full Time Instructional Staff - Teaching and Non-Teaching, Classified Managerial and Executive Compensation Plan
- PSC/CUNY Welfare Fund Data Sheet-to sign up for Welfare Fund benefits and add dependents. (This form is available in Human Resources)
- Health Benefits Buy Out Waiver Application-2009
Return with health benefits enrollment application,marriage/birth certificates and proof of non City health coverage - Guardian Dental Schedule of Allowable charges - as of 01/01/2007
- Guardian Dental Insurance - PSC-CUNY Welfare Fund. For out of network providers. Use Group Number G381084. Return form to Guardian
- Delta Dental - as of 01/01/2007
- Delta Dental - Enrollment/Change form
- Claim Form for Direct Optical Reimbursement (PSC-CUNY Welfare Fund)
- Drug Claims - Medco. Members of Medco either use their Drug Card at a pharmacy or use Mail Order. The most cost-effective way to buy long-term medications is to use Mail Order. Medco Mail Order Form If covered, but drugs were purchased, a Reimbursement Form is used.Medco Reimbursement Form
- Hearing Aid - Hearing Aid Reimbursement Form
- Wellness- Weight Watchers Reimbursement Form
- Optical Provider Listing-General Vision Services
- Optical Provider Listing-Davis Vision
-
Metlife Long-Term Care Program - or call 1-866-414-7076
Part Time Instructional - Teaching and Non-Teaching Adjuncts
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Adjunct Health Insurance Information
- Adjunct Health Insurance Certification Form (complete and forward to HR, HR will return to employee to send to PSC/CUNY Welfare Fund along with adjunct health plan enrollment form, available in HR)
- Teachers Retirement System (TRS) Tier 4 Information
- TRS Tier 4 Enrollment Application (return along with designation of beneficiary form)
Return notarized with a copy of birth certificate to Human Resources - Tier 4 Designation of Beneficiary Form (return notarized along with Tier 4 enrollment application)
- Adjunct Summary of Benefits
