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Group Catastrophe Major Medical Plan

The Group Catastrophe Major Medical (CMM) Plan, which is sponsored by the NYSUT Member Benefits Catastrophe Major Medical Insurance Trust, is coverage that supplements a basic health plan. This program is only available for purchase by local associations, their benefit funds and employers, and covers all group participants and their eligible dependents.

This plan is not available to individual members, who can click here for information on the NYSUT Member Benefits Catastrophe Major Medical Insurance Trust-sponsored voluntary Catastrophe Major Medical Plan.



PLAN ADMINISTRATION:
The NYSUT Member Benefits CMM Insurance Trust is the Administrator responsible for enrollment/eligibility and premium collection. Contact us at 800-626-8101 to ask questions and/or obtain a claim form. Customer service hours are weekdays from 9 a.m. to 5 p.m. (EST).

HealthSmart Benefit Solutions, Inc. is the Administrator responsible for claims processing and coordination of appeals for benefit period effective dates of January 1, 2018 and beyond.

Visit the HealthSmart website at healthsmart.com/nysut or contact them toll-free at 844-552-7805 to ask questions and/or obtain a claim form. HealthSmart’s customer service hours are weekdays from 8 a.m. to 5 p.m (EST).

Mercer Consumer is the Administrator responsible for claims processing and coordination of appeals for benefit period effective dates between January 1, 2014 and December 31, 2017.

Meanwhile, The United States Life Insurance Company in the City of New York is responsible for claims processing and coordination of appeals for benefit period effective dates prior to January 1, 2014.

Visit the Catastrophe Major Medical page on the Mercer Consumer website or contact Mercer toll-free at 888-386-9788 to ask questions and/or obtain claim forms for all benefit period effective dates prior to January 1, 2018. Mercer’s customer service hours are weekdays from 9 a.m. to 9 p.m. or Saturdays from 9 a.m. to 2 p.m. (EST).



MORE INFORMATION:
Both the 2019 Summary of Benefits & Coverage (SBC) and Group CMM Plan Highlights are available for viewing. Both documents are also available in paper form at no charge upon request by contacting Tammy Ross at NYSUT Member Benefits at 800-626-8101, ext. 1405 or tross@nysutmail.org.

With regard to how your medical information may be used and disclosed as well as how you can access this information, please refer to the NYSUT Member Benefits Catastrophe Major Medical Insurance Trust’s Notice of Privacy Practices. If you would like a copy of this notice mailed to you, contact Member Benefits at 800-626-8101 weekdays from 9 a.m. to 5 p.m. (EST).