Nyc retiree health benefits program irmaa

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1 Nyc retiree health benefits program irmaa PSC-CUNY Welfare Fund 61 Broadway, 15th Floor New York, NY The United States Life Insurance Company 3600 Route 66 P.O. Box 1581, MSN 2-E Neptune, NJ Select Health Benefits Videos Forms and Downloads Responsibilities & Health Benefits Assistance Choosing a Health Plan Enrollment Changes in Status Effective Dates of Coverage Health Plan Premiums Medicare Part B & IRMAA Coverage for Medicare-Eligible Retirees Termination and Reinstatement COBRA Special Continuation of Coverage Disability Benefits Contact the Health Benefits Program. Vision Benefit Reimbursement Form (Your Member ID# is your Social Security# unless you have specifically asked Davis to change it to another number.) IRMAA Medicare Part B Reimbursement (Instructions & Form) - Reimbursement was issued in April The New York Health Care Proxy Law

2 allows you to appoint someone you trust - for example, a family member or close friend - to make health care decisions for you if you lose the ability to make decisions yourself. Chair/unit head for approval and then forward approved leave to the Human Resources Department. Form 1054 (For Use By Authorized Personnel Only). Administrator PSC-CUNY Group Insurance Program P.O. Box Des Moines, IA Reimbursement for 2018 will be issued in October NYC Health Benefits Program Attention: Medicare Part B Differential Unit Church Street Station PO Box 3478 New York, NY PSC- CUNY Welfare Fund 61 Broadway, 15th floor New York, NY For most retirees, the refund is issued automatically by the Health Benefits Program. If you are currently receiving your pension check through Electronic Fund Transfer (EFT) or direct deposit, your reimbursement will be deposited directly into your bank account. This will be separate from your pension payment. If you don't have EFT or direct deposit, you will receive a check in the mail in June. The reimbursement amount is based on the standard Medicare Part B premiums. If your Medicare Part B reimbursement amount was less than what you paid in Medicare Part B premiums, excluding penalties, you may be eligible for an additional reimbursement amount referred to as a differential payment. To receive the differential payment, please complete the Medicare Part B Differential Request form (below). If you were eligible for Medicare Part B Reimbursement for prior years but did not enroll by providing a copy of your Medicare card, reimbursement is limited to the previous three (3) calendar years. To enroll, please complete the Medicare Part B Reimbursement Program Application. Mercer Consumer P.O. Box 9186 Des Moines, IA Office of Labor Relations Health Benefits Program 40

3 Rector St., 3rd floor New York, NY If you paid more than the standard monthly reimbursement rate for Medicare Part B, as an Income Related Monthly Adjustment Amount (IRMAA), you may be eligible for additional reimbursement. If you submit the required documentation for Medicare Part B IRMAA reimbursement, your reimbursement will be deposited directly into your bank account. Administrative Services Only, Inc Department # 178 P.O. Box 9009 Lynbrook, NY City of New York All Rights Reserved, Young Adult Option Through Age 29 (NYS Law Chapter 240) - January CVS Caremark PO Box Phoenix, AZ PSC-CUNY Welfare Fund 61 Broadway, 15th Floor New York, NY If you paid a Medicare Part B incomerelated monthly adjustment amount (IRMAA) during calendar year 2016 (which means more than the standard Medicare Part B monthly premium for 2016), you are entitled to additional reimbursement. Second Language Acquisition: Meeting the Needs of ELLS (LearnUFT Brooklyn). Medicare Part B, IRMAA checks to be issued in same year. The IRMAA reimbursement application is available on the UFT website for calendar year 2016 at. If you have any questions regarding the IRMAA reimbursement, please call a UFT health consultant at Starting this year, Medicare Part B Reimbursement and IRMAA checks will be issued in the same year. From Here to There: Engaging in Historical Thinking (LearnUFT Bronx). Thereafter, all future reimbursements will be issued in June for Medicare Part B and in October for IRMAA of the same calendar year. The New York City Office of Labor Relations will now begin processing IRMAA 2016 applications and the payment will be issued starting in October by scrolling down to the bottom of the page and clicking on the first quick link. It can also be accessed at the New York City Office of Labor Relations.

4 Advertise in the New York Teacher. Learn more >>. From Here to There: Engaging in Historical Thinking (LearnUFT Brooklyn). Medicare Part B, IRMAA checks to be issued in same year. first contact HearUSA at prior to your appointment to be eligible for a maximum $500 direct reimbursement. Young Adult Option Through Age 29 (NYS Law Chapter 240) - July NYC is a trademark and service mark of the City of New York. Administrative Services Only, Inc Department # 178 P.O. Box 9009 Lynbrook, NY Vision Benefit Reimbursement Form (Your Member ID# is your Social Security# unless you have specifically asked Davis to change it to another number.). Group Dental Claims P.O. Box El Paso. Texas PSC-CUNY Welfare Fund 61 Broadway, 15th floor New York, NY Young Adult Option Through Age 29 (NYS Law Chapter 240) - January IRMAA Medicare Part B Reimbursement (Instructions & Form) - Reimbursement was issued in April PSC-CUNY Welfare Fund 61 Broadway, 15th Floor New York, NY Form 1054 (For Use By Authorized Personnel Only). Chair/unit head for approval and then forward approved leave to the Human Resources Department. COBRA Form, Notice of Rights and COBRA Rates - July Mercer Consumer P.O. Box 9186 Des Moines, IA Office of Labor Relations Health Benefits Program 40 Rector St., 3rd floor New York, NY If you paid more than the standard monthly reimbursement rate for Medicare Part B, as an Income Related Monthly Adjustment Amount (IRMAA), you may be eligible for additional reimbursement. If you submit the required documentation for Medicare Part B IRMAA reimbursement, your reimbursement will be deposited directly into your bank account. CVS Caremark PO Box Phoenix, AZ Creditable Coverage Notice (Employees

5 Age 65 or Over). Vision Care Processing Unit P.O. Box 1525 Latham, NY Reimbursement for 2018 will be issued in October Administrator PSC-CUNY Group Insurance Program P.O. Box Des Moines, IA

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