Members of the part-time faculty can elect to participate in the university's health care and dental care plans as long as they meet the eligibility requirements set forth in the collective bargaining agreement between The New School and ACT-UAW. Part-time faculty members are eligible for health care and dental care plan coverage only after working at the university for at least one academic year (August–May). Newly hired part-time faculty members thus are not eligible for coverage during the first year of their employment at the university. Please review the Benefits Eligibility Criteria Checklist for Academic Year 2012-2013 to determine whether you are eligible for health care and dental care coverage through the university.
The university offers two health care plans with UnitedHealthcare (UHC). These plans do not require the designation of a primary care physician or referrals to see specialists. Refer to the Health Care Plan Comparison Chart (PDF) to view the differences in coverage between the plans and refer to the information below for specifics on each plan. If you have questions about coverage, call UHC at 888.322.2646.
Once you are enrolled, UHC will mail a membership card to your home address on record. The names of your covered dependents (if any) will also listed on your card. Present this ID card whenever you receive medical services or fill a prescription at the pharmacy.
UHC members portal and UnitedHealth Allies
When you receive your UHC card, go online to UHC's members portal, www.myuhc.com, and register your account using the ID and policy group numbers found on the front of your ID card. From the members portal, you can view plan benefits, claims information, complete your
personal health record, and gain access to UnitedHealth Allies, a health
discount program that can help you save money on a wide range of
health-related products and services not covered directly by most medical insurance.
To obtain forms and documents related to health care and prescription drug coverage go to the Benefits Forms and Documents section of this site.
Choice Plus 1000
The Choice Plus 1000 is a point-of-service (POS) plan that allows you to receive care from either UHC participating (in-network) providers or providers who do not participate in UHC's provider network (out-of-network). There is a $30 co-payment for in-network primary care physician office visits and a $50 co-payment for in-network specialist office visits. There is no co-payment for annual preventive care services. To find Choice Plus 1000 in-network providers go to www.uhc.com, click on "Find a Doctor" and select "UnitedHealthcare Choice Plus". You may also contact UHC at 888.322.2646 for provider information.
You can also receive care from out-of-network providers, but at a greater cost. The calendar year deductible (the amount you will pay in a calendar year for out-of-network services prior to expenses being considered for reimbursement) is $1,000 for employee-only coverage and $2,000 for family coverage.
Thereafter the plan pays 70 percent of the usual and customary rate (UCR); you are responsible for the remaining 30 percent of the UCR plus any billed amount exceeding the UCR. You must complete and submit to UHC a Reimbursement Claim Form (PDF) to receive reimbursement for out-of-network services.
The Choice Plus 1000 Summary of Benefits and Coverage (PDF) provides information on services covered by this plan.
Choice EPO Plan
The Choice EPO Plan covers only services received from UHC participating (in-network) providers. There is no coverage for services provided by non-participating providers except in the case of emergency care. To find Choice EPO in-network providers go to www.uhc.com and select "Find a Doctor" and UnitedHealthcare Choice. You can also call UHC at 888.322.2646 for provider information. There is a $25 co-payment for in-network primary care physician office visits and a $40 co-payment for in-network specialist office visits.
The Choice EPO Summary of Benefits and Coverage (PDF) provides additional information.
Prescription Drug Program
UHC's Prescription Drug Program is administered by Optum Rx. When filling a prescription at the pharmacy, present your UHC member ID card. The program has a three-tier co-payment structure, requiring the following co-payments for a one-month or 30-day supply at the retail pharmacy:
- $15 co-payment for tier 1 medications
- $25 co-payment for tier 2 medications
- $50 co-payment for tier 3 medications
To determine the co-payment tier associated with your medication, view the 2013 Optum Rx Advantage Prescription Drug List (PDF). Read the document carefully as pre-authorizations and quantity limitations may apply.
Prescriptions for medications taken on an ongoing basis (such as those for high cholesterol and high blood pressure) can be filled through the Optum Rx Mail Order Delivery Program. This program allows you to purchase a three month or 90-day supply of your medication for twice the retail co-payment amount. To begin mail order delivery, you must complete an Optum Rx Mail Order Form (PDF) and submit it to Optum with your prescription.
Please call UHC at 888.322.2646 if you have questions about prescription drug coverage.
Vision Care Benefits
UnitedHealthcare enrollees are automatically enrolled in the UnitedHealthcare Vision Plan at no additional cost. (You must be enrolled in the health care plan to receive vision plan benefits; there is no option to enroll separately.) The plan allows you to receive care from both participating (in-network) providers in the UHC's vision network and nonparticipating providers (out-of-network). You can search for in-network providers online at www.myuhcvision.com. The Vision Plan covers an examination and lenses (contact and glasses) every 12 months and new frames every 24 months. Review the Vision Plan Summary for details on how services and eye wear are covered under the plan.