Catastrophe Major Medical

Catastrophe Major Medical  

OVERVIEW

Once the deductible is satisfied, this plan provides benefits for eligible expenses that your basic plan may not fully cover. Coverage includes but is not limited to:

  • Supplemental medical insurance coverage designed to help with the expenses not fully covered by your basic major medical, prescription drug or hospitalization insurance - including Medicare
  • Limited nursing/convalescent home benefits up to $72 per day – $80,000 lifetime maximum benefit
  • Home health care benefits up to 25 hours per week – 6,000-hour lifetime maximum benefit


Please note: This coverage is not long-term care or nursing home insurance.

  • How Can I Enroll in the CMM Plan?

    NYSUT members cannot currently enroll in the CMM Plan. However, an open enrollment period will be held September 1, 2020 – September 30, 2020, for coverage effective January 1, 2021. Eligible NYSUT members and their eligible family members may enroll in the CMM Plan during open enrollment. In addition, current CMM Plan participants may add eligible family members who are not currently enrolled in the CMM Plan during this time. Please refer to the CMM Plan Highlights document for more details..


    Current CMM participants also have the ability to add dependents through a "life event" process which is outlined in the CMM Plan Document. Newly acquired dependents can be added within 60 days of the "life event." Contact us for details.

Tell Me More

Premium Payment Options

You may select from the following convenient payment options:

  • Payroll or Pension Deduction: If you belong to a local association that has made arrangements for payroll deduction of NYSUT Member Benefits endorsed/sponsored programs or if you are receiving a monthly pension benefit from NYSTRS, NYCTRS, or NYSERS, NYCBERS, or a monthly lifetime annuity payment from TIAA, you should consider taking advantage of this easy, convenient payment method. By doing so, you will save 10 percent on your premiums.
  • Pre-authorized check draft: Premiums will automatically be deducted from your checking account on a monthly, semiannual, or annual basis.
  • Pre-authorized credit card payments: Premiums will automatically be deducted from your credit card on a monthly, semiannual, or annual basis.
  • Direct bill: You will receive a billing invoice on a semiannual or annual basis.

 

How Do I File A Claim?

If your benefit period effective date is December 31, 2017, or before, please contact Mercer Consumer regarding claims processing. This applies to individuals who are submitting claims under the $15,000 or $25,000 deductible CMM plans. Please refer to the following details for claims under this plan:

Open Enrollment Period:

 

September 1, 2020 – September 30, 2020

Coverage Effective Date: January 1, 2021


Eligible NYSUT members and their eligible family members may enroll in the CMM Plan during open enrollment. In addition, current CMM Plan participants may add eligible family members who are not currently enrolled in the CMM Plan during this time. Please refer to the CMM Plan Highlights document for more details.

 

 

Forms

These form(s) and documents are in Adobe Acrobat Reader (PDF) format and are available for downloading and printing.

CMM Plan Document - Voluntary Plan
CMM Plan Highlights - Voluntary Plan
Catastrophe Major Medical Plan – Certificate $15,000
Catastrophe Major Medical Plan – Certificate $25,000
Catastrophe Major Medical Plan – Plan Document $15,000
Catastrophe Major Medical Plan – Plan Document $25,000
Catastrophe Major Medical Plan – Change Form
Catastrophe Major Medical Plan – Notice of Privacy Practices
Catastrophe Major Medical Plan - Domestic Partner Affidavit
Summary of Benefits and Coverage (SBC) - 2020
Glossary of Health Coverage and Medical Terms
Payroll Deduction Card
Pension Deduction Card
Contact Us

We're here to help! Please contact us in whatever manner is most convenient for you.

 Address
Mercer Consumer
PO Box 9186
Urbandale, IA 50306-9186
 Phone
1-888-386-9788
 Hours
9 a.m. to 9 p.m. Eastern, Monday-Friday and
9 a.m. to 2 p.m. Eastern, Saturday
 Email
customerservice.service@mercer.com
Mercer's Role & Compensation

Details of the Mercer disclosure of the compensation.