Eligibility (Retirees)

You are eligible for supplemental health insurance provided to retirees by the PSC-CUNY Welfare Fund if you meet all of the following requirements:

  • you are collecting a pension through a CUNY-related program
  • you are eligible for Welfare Fund benefits at the point of retirement
  • you are eligible for basic coverage through the NYC Retiree Health Program

Your coverage will depend on the year and conditions under which you retired from CUNY.  Depending on your circumstances, you may be eligible for Retiree Plan 82, Retiree Plan 80 or Retiree Plan 70.

Supplemental health insurance provided by the the PSC-CUNY Welfare Fund is designed to provide coverage for you and your eligible family members. Unless stated otherwise, if you are covered, your spouse (including a same-sex spouse) or qualified domestic partner and eligible dependent children are also covered.

This page includes only highlights of eligibility requirements. See the Details Tab for more information.

 

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Member Eligibility

Retirees are covered under the PSC-CUNY Welfare Fund at different levels of benefits depending upon the year and conditions under which the member retired from a covered title in the CUNY system. These differences result from variances in the employer contributions.

Retiree Plan 82 includes members who retired September 1, 1982, or later and who meet all of the requirements listed below.

Retiree Plan 80 includes members who retired prior to August 31, 1982, and who meet the Rule of 80 and who meet all of the requirements listed below. The Rule of 80 applies to retirees who-at the time of retirement-were at least 55 years old and whose age plus years of service in a covered CUNY title equaled or exceeded 80.

Retiree Plan 70 includes members who retired between June 30, 1970, and August 31, 1982 but who do not meet the Rule of 80 (described above) and who meet all requirements listed below.

Requirements

  • Must be collecting a pension through a CUNY-related program
  • Must be eligible for Welfare Fund benefits at the point of retirement
  • Must be eligible for basic coverage through the NYC Retiree Health Program

An eligible individual who waives coverage for self and or dependents (because of other health insurance or group health plan coverage) may be able to enroll at a later time if that other coverage is subsequently terminated or significantly altered. The individual must complete an updated Enrollment Form indicating the events requiring amended status. Coverage will not be effective until the Welfare Fund Office receives the necessary Enrollment Form/Data Sheet and any applicable proof of dependent status. If the Welfare Fund Office receives the request for enrollment in these circumstance within 30 days of the event, coverage will be retroactive to the date of the event. If it is received after 30 days, coverage is effective the first of the month following receipt of the completed enrollment material.

The same provisions apply if an individual or dependent loses coverage through Medicaid or a State Children's Health Insurance Program (CHIP). If the Welfare Fund Office receives the request for enrollment due to loss of coverage in Medicaid or a CHIP or because of eligibility for a premium assistance program within 60 days of the event, coverage will be retroactive to the date of the event. If it is received after 60 days, coverage is effective the first of the month following receipt of the completed enrollment material.

Please note that the above does not apply to the Optional Benefits. There are special eligibility and enrollment rules for the Optional Benefits made available to Plan participants.

Dependent Eligibility

If you are covered, your spouse/same sex spouse/qualified domestic partner and/or eligible dependent child(ren) are covered. Domestic partners are qualified if duly registered with the New York City Clerk's Office. Certain tax implications apply to benefits for domestic partners. These may be reviewed with qualified tax professionals. As of July 1, 2011, the Fund defines eligible dependent children as natural or adopted children who are a) under age 26 or b) totally and permanently disabled and who became so prior to their 19th birthday. Coverage for dependent children (not disabled) ends on the last day of the month that children turn 26.

Enrollment

Benefit officers employed at each CUNY campus in the Human Resources Department provide eligible persons with information packets and enrollment applications for both the basic health insurance plans and Welfare Fund supplemental benefits. Completed applications must be returned to the Human Resource office for processing. Welfare Fund applications are forwarded to the PSC-CUNY Welfare Fund by the college.

Termination of Coverage

Retirees have lifetime coverage. Coverage for dependents ceases upon the death of the participant. Benefits may be continued by purchase options (see COBRA and Survivor Benefits).