Not For Women Only – Paraprofessional Ed.

Nov 1, 2003 12:47 PM

Medical Benefits/SLOAC

What happens to my medical benefits during a child care leave?

Health coverage is provided during a child care leave only if you are on an FMLA leave.

What happens to my medical benefits during a leave of absence without pay for restoration of health?

Members who are on an approved leave of absence without pay for restoration of health are eligible for four months of Special Leave of Absence Coverage (SLOAC) benefits paid for by the DOE. If you are disabled, the UFT Welfare Fund will pay for up to eight additional months. The coverage is identical to what you had while working.

What are the rules about receiving SLOAC?

To receive SLOAC you must meet three conditions:

1. You must be enrolled in the city health insurance program and be on pay status for a full payroll period prior to leave.
   
2. You must exhaust all sick leave balances prior to the effective date of the leave of absence for restoration of health.
   
3. The leave must be approved by the DOE’s Medical Bureau.

How do I apply for SLOAC?

On Form EB 1054. Your school payroll secretary submits the form with the words “SLOAC—leave of absence without pay for restoration of health” written on it. Be sure to include the beginning and end dates.

I have enrolled in the GHI/CBP health plan. In general terms, what are my Blue Cross hospital maternity benefits?

Women are eligible for regular hospital benefits for all pregnancy-related conditions. There is a $200 hospital deductible on all hospital admissions, including maternity. You should contact the New York City Healthline (800/521-9574) as soon as you learn you are expecting.

Will Blue Cross cover my newborn child for full hospital benefits?

Yes, but you must add your new dependent by filling out an ERB form within 31 days of the date of birth as well as the UFT Welfare Fund Change of Status card. A copy of the birth certificate must accompany these forms. If you do not file within 31 days, you will not be allowed to add your new dependent until the next open enrollment period.

What are my maternity care benefits in the GHI/CBP health plan?

You are covered for childbirth and for conditions related to pregnancy. Maternity care may be rendered by a doctor or certified nurse-midwife. The nurse-midwife must be authorized to perform the service under the laws of the state where the services are rendered.

Benefits are available for maternity immediately upon enrollment. There is no pre-existing condition clause or waiting period. If you so desire, GHI can pay its obstetric allowance at the end of each trimester (15 percent, 25 percent and 60 percent respectively). Please note that when using a non-participating provider you are required to meet the deductible as with any other covered medical service.

You should consider using a participating GHI doctor and anesthesiologist. Your savings will be considerable. (For more details check the New York City Summary Program Description and GHI’s and Empire Blue Cross’ booklet, For City of New York Employees and Retirees.)