Supplemental Medical Benefit
The Supplemental Medical Benefit provides coverage for benefits that are not completely covered by the City-provided health plan or not covered at all by the basic health plan. The benefits are reimbursed at 80% of the approved charge, once a $ 150 per person / $ 450 per family deductible is met, to a maximum of $ 2,000 per person per year. There are special exceptions to this guideline, and members are advised to consult their CSA Welfare Benefits Book , or call the Fund office, for specific illustrations.
Catastrophic Stop-Loss Benefit
This benefit provides for reimbursement of out-of-pocket cost not paid by the basic health plan. After a $ 1,500 deductible, the Fund reimburses you at 80% for the next $ 1,250 of approved costs, then reimburses you at 100% until it has paid a maximum of $ 50,000 in a calendar year. Deductibles and co-insurance charges from the primary carrier are included in this benefit, as are charges for using non-participating providers. This unique benefit provides a safety net for our members, and relieves them of a major financial burden should they experience a catastrophic illness. Please contact the Fund office if you have any questions regarding this benefit
