Health Maintenance Organizations (HMO) 
An HMO is a system of health care that provides managed, pre-paid hospital and medical services to its members. A member chooses a Primary Care Physician (PCP) from within the HMO network, and the PCP manages all medical services, provides referrals, and is responsible for non-emergency admissions. There is little or no out-of-pocket expense provided that members and their families use HMO doctors and facilities.

The following health provider carriers are HMOs available through the City:

Aetna HMO                                                   HIP Prime HMO
CIGNA HealthCare                                         HealthNet
Empire HMO                                                 Vytra Health Plans
GHI HMO 

Empire (EPO) Exclusive Provider Organization 
An EPO plan offers a higher level of choice and flexibility than many other managed care plans. Members can see any provider in the EPO network, which contains family and general practitioners as well as specialists in all areas of medicine. There is no need to choose a PCP and no referrals are necessary to see a specialist. There are no claim forms and members will never have to pay more than the co-payment for covered services. 

HIP Prime (POS) Point-of-Service 
A POS plans offer the freedom to use either a network provider or an out-of-network provider for medical and hospital care. If the subscriber uses a network provider, health care delivery resembles that of a traditional HMO, with prepaid comprehensive coverage and little out-of-pocket costs for services. When the subscriber uses an out-of-network provider, health care delivery resembles that of an indemnity insurance product, with less comprehensive coverage and subject to deductibles and/or coinsurance. 

GHI-CBP (PPO)/Indemnity Plans Participating Provider Organization 
A PPO/Indemnity Plan offers the freedom to use either a network provider or an out-of-network provider for medical and hospital care. PPO/Indemnity Plans contract with health care providers who agree to accept a negotiated lower payment from the health plan, with co-payments from the subscribers as payment in full for medical services. When the subscriber uses a non-participating provider, the subscriber is subject to deductibles and/or coinsurance.

Aetna Quality Point of Service (QPOS)
The QPOS offers all the comprehensive benefits of the Aetna US Healthcare HMO plan with the added freedom to “self-refer” – choose to use out-of-network providers or visit network doctors without a Primary Care Physician (PCP) referral.

DC 37 Med-Team/Choice (available only to DC 37 members, retirees, and their families). 
The plan offers a full range of coverage and more choices. Depending on the health care service you need, you are free to get care from providers participating in your Empire PPO network or you can choose to use outside providers

Information pertaining to the rates for the above plans can be obtained from the Human Resource Department. All rates are subject to change.


Disability

Family Medical Leave Act of 1993 (FMLA)
As a full time employee of CUNY you are eligible for short-term leave under FMLA, which permits a 12 week paid or unpaid leave for personal health reason or for the care of a family member. For information, please contact the Human Resource Department.

Workers’ Compensation
As an employee of CUNY you are covered by workers’ compensation benefits if you suffer a job-related injury or illness, obtain emergency medical treatment immediately and then contact the Human Resource Department.

Flexible Spending Accounts

Flexible Spending Accounts are available for two types of expenses, health and dependent care. They are funded through pre-tax payroll deductions, thereby reducing your taxable income. The Health Care Flexible Spending Account (HCFSA) helps pay for health-related expenses not paid by your health, dental or vision insurance. The Dependent Care Assistance Program (DeCAP) Spending Account provides the opportunity for you to use tax-free dollars to pay for the expenses to care for your children or other dependents while you and your spouse work (or go to school full-time). To participate in the HCFSA or DeCAP programs you must complete and return an Enrollment/Change Form during the Fall Enrollment period. For the plan year, the period of coverage is from January 1st through December 31st. Enrollment is not automatic from year to year – you must re-enroll each year during the annual enrollment period.