CUNY Graduate Center

Student Health Insurance

and Selected Resources:

A Guide

The information within is provided solely for informational purposes and is not intended to be an exhaustive review or to endorse, recommend, or otherwise favor any given health insurance plan or health resource option over another. Questions about health insurance or the contents of this guide should be addressed to Ellen Zitani (ezitani@gc.cuny.edu) or Elise Perram (eperram@gc.cuny.edu) in the Office of Student Affairs.

Office of the Vice President for Student Affairs

August 2008

Table of Contents

Section A: General Information

Introduction

Email from President Kelly

Message from Chancellor Goldstein

Note on General Costs for Insurance Coverage

How do I choose a Health Plan?

Things to consider while selecting a health insurance plan:

Health Insurance Plan Comparison Worksheet

The Graduate Center Wellness Center

Psychological Counseling and Adult Development Center

Section B: Public and State Sponsored Health Insurance Programs

Definitions

State Sponsored Programs

Medicaid

Family Health Plus

Child Health Plus

Healthy NY

Dental Plans and State Sponsored and Public Programs

International and Visiting Fellows and Public Programs

Student Income and Publicly Funded Programs

Enrollment Facilitators for Public and State Sponsored Programs

Section C: Affiliated or Group Insurance Policies

General Information on Affiliated or Group Insurance Policies

Some Advice on How to Chose a Plan

CUNY Review of Insurance Policies

The CUNY GHI Program for Domestic and International Students

Domestic Partners and GHI

PSC-CUNY Adjunct Health Coverage

COBRA and the PSC Health Insurance

The PSC and the New NYSHIP Program

The American College Association Insurance Plan

International Students and the ACSA

Coinsurance and the ACSA

National Association of Graduate-Professional Students

NAGPS and Coinsurance

Section D: International Student and International Visitor Plans

International Student and Exchange Visitor Insurance Chart

Section E: Commercially Rated and Membership Organizations

Commercially Rated Programs

Introduction to HMOs, POS, and EPO

Some Rates for Commercially rated HMO and POS Plans

Membership Organizations

The Workmen’s Circle

The International Women’s Writing Guild

Freelancer’s Union

Section F: Dental Plans

Student Rated Plan: The Stu-Dent Plan

Commercial Plans

Community Dental Clinics

Section G: Community Vision Clinics and Commercial Vision Programs

Community Vision Clinics

Commercial Vision Programs

Section H: Prescription Drug Information

Section I: Local Health Clinics and Hospitals

Lists of Low-Cost or Free Clincs

Local health Care Clinics

STUDENT HEALTH INSURANCE AND

SELECTED RESOURCES: A GUIDE

Section A – GENERAL INFORMATION

INTRODUCTION

This guide to student health insurance and selected health resources is prepared by the Office of The Vice President for Student Affairs solely for informational purposes and is not intended to be an exhaustive review or to endorse, recommend, or otherwise favor any given health insurance plan or health resource option over another. It is prepared to aid you in understanding the health insurance marketplace as you research the correct options for yourself and, as applicable, for partners and children. In addition to researching the options described in this guide, if you or your partner is employed, you should inquire about insurance coverage provided by the employer; and explore any group insurance plans offered through professional, alumni, and fraternal associations of which you may be a member.

The following is a message from President Kelly regarding the upcoming NYSHIP insurance for selected categories of Graduate Center student employees. Please note that until this program is implemented, Graduate Center students continue to procure their own health insurance. Therefore, the remainder of the information in this guide is designed to help you find insurance that will best suit you and your family’s needs.

An email from Graduate Center President, William Kelly:

The following communication regarding the state of health insurance for selected categories of Graduate Center student employees was sent to the Graduate Center Community on July 23, 2008:

Dear Friends,

On Monday, July 21, the Executive Committee of the Board of Trustees unanimously and enthusiastically approved a resolution authorizing CUNY’s participation in the New York State Health Insurance Program (NYSHIP). As you know from my earlier message, this approval was necessary before we could begin to enroll doctoral students employed at the university in the NYSHIP program. The Board’s action, in conjunction with a parallel agreement by the PSC, moves us another step closer to our goal. We will now focus our efforts on working with NYSHIP to expedite the enrollment of eligible students. I will, of course, keep you posted on our progress.

I would be remiss not to mention that the Board’s action came at no small cost. Until the state agrees to cover the substantial subsidy required by this program, the university has agreed to self-fund that expense. In an extremely difficult budget year, this new measure of support for doctoral education would be remarkable were it not entirely consistent with past practice. Five-year recruitment packages, tuition remission, and targeted faculty recruitment initiatives are only the most obvious investments Chancellor Matthew Goldstein has made in CUNY’s doctoral programs. We are once again in his debt.

Best wishes,

Bill Kelly

A message from the Chancellor, William Goldstein:

Sent to the CUNY Graduate Center Community sent July 23, 2008:

On July 21, the Executive Committee of the CUNY Board of Trustees approved three measures to enhance the quality of services offered to students at the University, from health benefits to improved technology. I am deeply grateful to the members of the Executive Committee and to all of those within the CUNY community whose diligent work and careful deliberations allowed these important measures to move forward.

The Executive Committee approved an agreement that will enable CUNY to participate in the state-sponsored Student Employee Health Plan (through the New York State Health Insurance Program) on behalf of its eligible doctoral students. In 2008-09, we expect that approximately 2,400 CUNY doctoral students who are employed as adjunct lecturers, adjunct instructors, adjunct college laboratory technicians, or non-teaching adjuncts will be eligible for the new health benefits. CUNY will pay 90 percent of the cost of individual coverage for doctoral students who elect to participate in the plan and 75 percent of the additional cost of dependent coverage for eligible dependents of doctoral students. I am delighted that the University can extend this important benefit to its doctoral students.

A Note on General Costs for Insurance Coverage:

Traditionally, insurance policy costs are based on claim usage within the population as determined by demographic factors like age and medical history. Students within specific age ranges are presumed to make either more or less use of their policies according to the age range into which they are grouped (with a median age selected). This is why student-rated policies are generally less expensive than most commercial policies not made available through an intermediary like CUNY or provided through an employer or otherwise subsidized, but in general they do not offer as many benefits as do the commercial policies. In addition, they sometimes employ an age-related, or payment-tier system (NAGPS does this; GHI does not). No matter what your age, if you are eligible for public-funded health programs that meet your particular needs, some may be less expensive than student-rated policies and may offer better benefits.

It is important to note that the costs of insurance policies are sometimes subject to change during the academic year by (usually) modest increments. In other words, the price for an insurance policy in September will most likely be lower than the price for the same policy in January. Also, in planning how to meet your needs for health insurance coverage, take into account that should the qualifying conditions for eligibility for a particular insurance plan end, the timing may be such that you do not immediately have another option for health insurance coverage. In other words, if you are a full-time student who might switch to part-time in 08-09, this might affect your coverage if you are enrolled in a student insurance plan.

How do I chose a health plan?

The information in this section is intended to aid you in the sometimes overwhelming process of selecting the insurance plan that best suits you and your family.

Things to consider while selecting a health insurance plan:

The following is intended to be used as a check-list that will help you consider the benefits offered by various health insurance plans. Because each plan is different, we encourage you to ask yourself these questions, as well as fill out the worksheet (4b) before making a final decision for you and/or your family. After looking through this booklet, use the following check-list and worksheet to compare your options.

Will you be eligible for the NYSHIP program once it is in place?

If you are an adjunct or a fellow teaching or working at one of the CUNY schools, you may be eligible in the future for the new NYSHIP insurance.
Therefore, you may want to purchase insurance on a monthly basis now, until the NYSHIP plan is in place.
If you purchase a yearly plan now (such as NAGPS or paying in full for GHI), you may end up over-paying.

Can you get insurance from an association you belong to? Many of the following offer health insurance:

o Alumni Associations

o Fraternities and Sororities

o Workers or Professional Organizations

Honor Societies
Freelancers Union (see Section E of this guide)

Public or Private Health Insurance?

o Does your monthly income qualify you for Family Health Plus or Healthy New York? (See Section B of this Guide)

o Healthy New York’s costs can be similar to private plans or student plans such as GHI – be sure to weigh the benefits and restrictions of each before choosing.

o Remember that Healthy NY does not cover mental health. GHI does cover mental health, but does not include prescription drug coverage. So individuals who need psychiatric care should weigh the costs of both programs carefully and choose based on the cost of their prescriptions and doctor’s visits.

Are you aware of all of the costs associated with the plan?

o Monthly premiums

o Deductibles*

o Co-pays

o Co-insurance**

Prescriptions

HMO or PPO?

o HMO’s typically have lower premiums, but less choice of medical providers (patients must remain in-network for health care)

o PPO’s provide greater choice of providers, but may have higher premiums

Is your doctor and hospital in the network?

o Each provider has a different network. Be sure to check their websites for your preferred medical professionals and hospitals.

Does the plan cover your specific medical needs or conditions? The following services may not be covered:

o Pre-existing Conditions

o Prescription Drugs

o Chiropractic

o Alcohol and Drug Rehabilitation

o Mental Health

o Holistic and Wellness Services

o Nutrition

o Podiatry

o Long-Term Care

o Ambulance

o Emergency Room Visits

o In-Patient Hospital Care

o Out-Patient Hospital Care

o Annual Doctor’s Visits

Is the insurance for you only? Or do you need a plan for you, your spouse/partner and/or your child(ren)?

o The costs change dramatically if you are considering a plan that includes your spouse/partner and/or child(ren).

o Remember that even if you select a private insurance for yourself, you may still be eligible to enroll your child(ren) in Child Health Plus (See Section B of this guide).

o Domestic partner coverage varies depending on provider. Be sure to find out if the program you select will insure your partner too.

Health Insurance Plan Comparison Worksheet:

You may want to use this worksheet to help you compare plans in this booklet, or plans that are available to you through other means such as alumni associations, professional organizations, honor societies, etc.

Directions: Fill in the names of the insurance plans that you are considering in the top row. Answer the questions for each plan in the column below where you wrote the plan name. Add up the total costs at the bottom to see what your annual estimate would be. You will have to estimate the cost of your co-pays, co-insurance and prescriptions. It is best to do an annual estimate, because some costs (such as co-insurance, co-pays or prescriptions) are not incurred monthly.

Plan Names →
Do I meet the income requirement?
Does this plan include care for my specific medical needs?
Is my doctor in this network?
Annual Premium	$	$	$	$
Annual Deductibles*	$	$	$	$
Annual Optional Major Medical	$	$	$	$
Annual Co-Pays (estimate)	$	$	$	$
Annual Co-Insurance** (estimate)	$	$	$	$
Annual Prescriptions (estimate)	$	$	$	$
Total Annual Cost	$	$	$	$

*Not all insurance plans have annual deductibles. An annual deductible is the amount you must spend on medical services before your insurance company will begin to pay. For example, NAGPS’ low payment cost option has a $500 deductible you must meet before they begin to pay for their share of the co-insurance.

** Co-insurance is when the insurer and the insured share the cost (usually an 80%/20% split) after the deductible has been met. Some insurance plans, such as NAGPS, have this as an option in order to provide lower monthly premiums. For example, if you had a hospital bill of $20,000 – you would be responsible for $4,000 and the insurance company would be responsible for $16,000.

The Graduate Center Wellness Center:

One set of health resources available to registered Graduate Center students, whether their academic programs are based at the Graduate Center building or largely at one of the other City University of New York campuses, is the Graduate Center Wellness Center, which consists of Student Health Services and The Psychological Counseling and Adult Development Center. Their services are described below.