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

Click here to read about recent group health plan compliance regulations and the CMM Plan’s position on their applicability to the Plan.

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

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:

• Voluntary Catastrophe Major Medical Plan – Claim Form for Benefit Periods Prior to 1/1/18
• Group Catastrophe Major Medical Plan - Claim Form for Benefit Periods Prior to 1/1/18
• Group Catastrophe Major Medical Plan - Critical Illness Form for Benefit Periods Prior to 1/1/18
• CMM Plan – Claim Reference Guide for Benefit Periods Prior to 1/1/18