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 NYSUT members, who can click here to learn more about 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 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 or later.

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

Association Member Benefits Advisors (AMBA) (formerly Mercer Consumer) is the Administrator responsible for claims processing and coordination of appeals for benefit period effective dates prior to January 1, 2018.

Visit the Catastrophe Major Medical page on the AMBA website or contact AMBA toll-free at 888-386-9788 if you have any questions and/or to obtain claim forms for all benefit period effective dates prior to January 1, 2018. AMBA's hours are weekdays from 9 a.m. to 7 p.m. (EST).

MORE INFORMATION:
The Summary of Benefits & Coverage, Glossary of Health Coverage & Medical Terms, and Group CMM Plan Highlights are available for viewing. These documents are also available in paper form at no charge upon request by contacting NYSUT Member Benefits at 800-626-8101.

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 CMM 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).

Click here to read about recent group health plan compliance regulations and the CMM Plan's position on their applicability to the Plan.