Vision
Outpatient Psychiatric
Prescription Drug
House Staff Benefits Plan[/vc_cta][/vc_column][vc_column width=”1/3″][vc_cta h2=”Contract” txt_align=”center” style=”outline” color=”peacoc” add_icon=”top” i_icon_fontawesome=”fa fa-file-text” i_color=”white” i_background_style=”rounded” i_background_color=”peacoc” css_animation=”slideInUp” i_on_border=”true” i_link=”url:http%3A%2F%2Fwww.cirseiu.org%2Fwp-content%2Fuploads%2F2017%2F04%2F2010-2018-NYC-HH-Contract-Final.pdf|||”]Professional Learning Plan: $650/year
Meal Allowance: $2,900/year
Childcare Benefit: $5,000/year
Conference Benefit: $1,500/3 years
Open your Contract[/vc_cta][/vc_column][vc_column width=”1/3″][vc_cta h2=”Residency & Legal” txt_align=”center” style=”outline” color=”juicy-pink” add_icon=”top” i_icon_fontawesome=”fa fa-gavel” i_color=”white” i_background_style=”rounded” i_background_color=”juicy_pink” css_animation=”slideInUp” i_on_border=”true” i_link=”url:http%3A%2F%2Fwww.cirseiu.org%2Fwp-content%2Fuploads%2F2018%2F06%2FFINAL-HSBP-CIRLS-SPD-May-2018-Reprint_Client-Version_06062018.pdf|||”]Continuing Learning Program
Professional Educational Benefit
Disability
Legal
CIR Legal Services[/vc_cta][/vc_column][/vc_row][vc_row][vc_column][vc_empty_space height=”50px” el_id=”jump”][vc_custom_heading text=”Benefits & Forms” font_container=”tag:h1|font_size:34|text_align:center” google_fonts=”font_family:Libre%20Baskerville%3Aregular%2Citalic%2C700|font_style:400%20regular%3A400%3Anormal”][/vc_column][/vc_row][vc_row][vc_column][vc_tta_tour style=”modern” color=”juicy-pink” alignment=”center” active_section=”1″][vc_tta_section i_icon_fontawesome=”fa fa-user” add_icon=”true” title=”Personal Information” tab_id=”1526918401596-4f608d9d-f7d5″][vc_column_text]Submit paper forms by mail or fax to:
Voluntary House Staff Benefits Plan | 520 Eighth Avenue Suite 1200 | New York, NY 10018 | Fax: (212) 356-8181
Personal information:
- Membership Form
- Update Form* to add new dependents to your plan. Requests to add dependents must be received within 30 days of qualifying event (birth/adoption or marriage), and you must attach requested documentation (see form)
- Domestic Partnership Application (same-sex and opposite partners eligible). To add a partner, download an application below and return a notarized copy, along with all requested documentation, to the Plan office.
- Opt-Out Form* Please fill out this form if you would like to remove yourself and/or your dependent(s) from the CIR Benefits Plan.
- Empire Health Insurance Claim Form (out-of-network)
[toggle_content title=”Prescription”]
- Prescription – Express Scripts (HHC Residents Only)
ESI benefits:
About this benefit:
This benefit is a supplemental RX coverage that should be used in conjunction with your employer’s primary prescription plan. The Plan highly recommends the member enroll in the employer prescription plan for themselves and their family. Whenever possible use your primary prescription carrier prior to the supplemental debit card. Employees will be mailed two cards per household and informational materials. You may use the cards immediately.
Please note: Employees and their dependents may not be issued a card if a completed enrollment card was not presented to the benefits office. Cards will be issued at $750 per eligible individual in the family. Members can obtain discounts for prescription drugs at any one of ESI’s participating providers nationwide. The card acts like a debit card. Cards are presented to the participating pharmacy for eligibility verification. Once eligibility is established, the cost of the prescription will be reduced by a discounted rate. Members will not have to pay any cash/payment upfront. When the balance on the card reaches zero, members can continue to use the cards to fill prescriptions at a discounted price.
In the event the card does not have a sufficient balance to pay for the full prescription, the cost of the purchase will be applied to the card and the remaining balance will be the member’s responsibility. Members are highly encouraged to submit any out of pocket cost for reimbursement.
It is important to note this card does not cover any over the counter drugs or medications. To determine the participating providers, you can logon and register at www.express-scripts.com or call the customer service phone number on the back of your card. ESI’s customer service representatives can also inform you of your card balance. Claim forms can be found at https://www.cirseiu.org/benefit
For additional savings you can use ESI’s mail order program to get a ninety day supply for the cost of two copayments. For replacement of a lost card, please contact ESI @ 1-800-467-2006.
[/toggle_content][toggle_content title=”Vision”]
Davis Vision benefits:
[/toggle_content][toggle_content title=”Dental”]
Guardian Dental benefits:
Dental Guard Preferred – DGP (This Benefit is insured through HSBP):
If the employee or eligible dependent is enrolled in the DentalGuard Preferred through Guardian or another carrier, this supplement will pay an additional 20% to the member, of the amount reimbursed by the dental carrier for covered services. This 20% supplement will be calculated based on the total reimbursements received under the Dental Plan during the benefit year.
For Example: Managed DentalGuard – MDG
If the employee or eligible dependent is enrolled in the Managed DentalGuard, this supplement will pay 20% of what the employee has paid in connection with receipt of covered Managed DentalGuard. With your claim form, you must submit an itemized statement of covered charges from your primary care dentist with the exact date(s), diagnosis and procedure codes for which services were rendered. Only services that are covered by your dental carrier will be reimbursed by the Plan. Scanned copies of your receipts for eligible dental expenses must be submitted to the Benefits Plan Office with the appropriate claim form. The Managed DentalGuard or DentalGuard Preferred reimbursements in combination cannot exceed the maximum supplement per person per benefit year of $1,000.
[/toggle_content][toggle_content title=”Hearing”] [/toggle_content]
[toggle_content title=”Supplemental Benefits”]
- Mental Health*
- Major Medical – Supplemental*
- Obstetrical – Supplemental*
- Newborn Expenses*
- Urinalysis Monitoring
The HSBP Transgender benefit gives those who need the ability to receive medical services such as psychology, hormones and surgery to develop the physical characteristics of the desired gender. Transgender benefit coverage includes: culturally appropriate, knowledgeable primary care and prescription care, access to gender specific care, transition-related care and mental health outpatient care. Read more here
[/toggle_content][/vc_column_text][/vc_tta_section][vc_tta_section i_icon_fontawesome=”fa fa-wheelchair-alt” add_icon=”true” title=”Disability” tab_id=”1526918482791-58a4f169-aa08″][vc_column_text]Submit paper forms by mail or fax to:House Staff Benefits Plan | 520 Eighth Avenue Suite 1200 | New York, NY 10018 | Fax: (212) 356-8181
Disability:
- Disabled Health Premium Reimbursement
- Short-term Disability
- Long-term Disability
- INSMED Portable Disability Coverage – Policies offered to you without any medical underwriting requirements or exams.
- Continuing Learning Program* (formerly Conference Reimbursement) our NEW secure web form is here! For changes to Plan rules and eligibility, refer to Summary Plan Description (SPD).
- Professional Education Plan (PEP)* reimburses costs associated with books, board exams, medical licensure fees, dues, subscription, journals, and mobile electronic medical devices. For changes to Plan rules and eligibility, refer to Summary Plan Description (SPD).
- QI Training & Education Application*
- QI Training & Education Reimbursement Form* (For those who have been previously approved for this benefit)
- Rosetta Stone Claim Form*
Are you a resident or fellow in need of childcare? You’re in luck!
Housestaff with children 13-years-old or younger are eligible for reimbursement of up to $5,000 per calendar year as of January 1, 2017 for childcare expenses.
To qualify:
- You must be a resident or fellow at a New York Health + Hospitals (NYC H+H) facility
- Your child or children must be 13-years- old or younger
- Your expenses must qualify as tax- exempt per IRS Publication 503
- Submit a reimbursement form with paid receipt and other required documentation
You can fill out a reimbursement form and find more info below:
House Staff Benefits Plan | 520 Eighth Avenue Suite 1200 | New York, NY 10018 | Fax: (212) 356-8181
COBRA:
COBRA (continued health insurance after hospital closure or layoff). If you are electing COBRA for the first time, you must complete the Election Form and Payment Form. If you are changing or updating an existing credit card, complete the Payment Form only.
[/vc_column_text][/vc_tta_section][vc_tta_section i_icon_fontawesome=”fa fa-undo” add_icon=”true” title=”Appeal & Claim Reprocess” tab_id=”1529602966354-9bb431eb-7a87″][vc_column_text]Appeal & Claim Reprocess:- HSBP Appeal* Complete this form if your claim was denied in whole or any part or if you disagree with the decision that was made.
- HSBP Claim Reprocess Form* Complete this form if your claim was denied and you are able to provide additional information.
- Benefits At-A-Glance – a comprehensive summary of all the available benefits
ID Theft Solutions of America*[/vc_cta][/vc_column][vc_column width=”1/2″][vc_cta h2=”Education Loan Debt Benefit” style=”outline” color=”vista-blue” css_animation=”appear” use_custom_fonts_h2=”true”]HSBP CIR Legal Services (CIRLS)
[toggle_content title=”More information”]- You are eligible for an individual education loan consultation at a 60% discounted rate.
- Consultation includes a review of your loan portfolio and a discussion to ensure you are positioned to obtain the maximum savings and lowest payment available. Consultations may be held in-person or conducted over the phone.
- In addition, you can purchase an education loan paperwork processing service to prepare and submit the documentation necessary for your loan repayment option.
- You could potentially save thousands of dollars during the length of your loan.
Click here for more information
The first step to get these benefits is to contact CIR Legal Services and we can be reached at (212) 356-8195.
[/toggle_content][/vc_cta][/vc_column][/vc_row][vc_row equal_height=”yes” css_animation=”fadeIn”][vc_column][vc_empty_space height=”50px”][vc_text_separator title=”Delegates” color=”violet” border_width=”2″][vc_row_inner][vc_column_inner width=”1/6″][vc_column_text]
Bellevue Hospital
Danielle Brewington
Shelley Varnado
Coney Island Hospital
Ernesto Blanco
Tatyana Joab
Tony Klochkov
Kings County Hospital
Odeth Barrett-Campbell
Latoya Freeman
Dani Holmes
Tracian James-Goulbourne
Harlem Hospital
Adelaide Oppong
Woodhull Hospital
Heidi Peynado de Pena
[/vc_column_text][/vc_column_inner][vc_column_inner width=”1/6″][vc_column_text]Lincoln Medical
Antonio Lubrano
Meghna Shah
Jacobi Medical Center
Carlo Lutz
Kendall Moore
