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Human Resources

CCNY Benefits Forms

Updated Friday, March 6, 2015, 4:06 pm

ADJUNCT HEALTH BENEFITS

Adjuncts are eligible for health benefits as a Teaching or Non-Teaching Adjunct, if you meet the
following eligibility requirements:

Teaching Adjunct: Completed two (2) consecutive semesters of at least one or two courses per
week of Adjunct instruction for the full semester at CUNY immediately prior to the current
semester; teaching at least six (6) hours per week for the full semester, which must be
maintained.

Non-Teaching Adjunct: Completed two (2) consecutive semesters of at least 15 hours per week
for the full semester at CUNY immediately prior to the current semester working at least 15 hours
per week for the full semester;.
Note: The summer or winter "session" is not considered towards meeting the eligibility
requirement.

Be Advised: If you are currently not covered by or eligible to be covered by any other health insurance plan by
virtue of employment of self or spouse or through government entitlement, then you may be
eligible to be enrolled in health benefits through the New York City Health Benefits Program
administered through the CUNY University Benefits Office. The enrollment forms can be
obtained from the site below and your Benefit Officer will need to verify that the eligibility
requirements have been met. If eligibility is due to your employment at two campuses, you will be
required to obtain verification from each campus. Some employee plans are available free of
charge, and dependent health insurance coverage is available through premium payment. For
detailed information, visit http://www.cuny.edu/benefits, under Benefits at a Glance, Adjuncts
Teaching and Non-Teaching.

Adjunct Health Benefits Forms

PSC-CUNY WELFARE FUND Eligibility for Adjuncts

PSC-CUNY Adjunct FAQ Sheet

Adjunct Health Benefits Packet

Alternative Coverage: Insurance Marketplace


Full-Time Faculty and Staff Benefits Forms

Health Benefits Application

Health Plan Rate Sheet


Retirement Forms

Full-Time Teaching and Non-Teaching Instructional Staff
Teacher's Retirement System Application
PSC-CUNY Choosing a Retirement Plan Info Sheet
Retirement Election Form

Classified Staff
NYCERS Enrollment Application


Voluntary Retirement Forms

2015 Salary Reduction Agreement

Full-Time Teaching and Non-Teaching Instructional Staff

TIAA-CREF

Deferred Compensation

Haliday Financial



Dedicated/Catastrophic Sick Leave Policy

Dedicated Annual/Sick Leave Program
Catastrophic Sick Leave Bank Program (CSLB)

(Application to Donate
and Application to Receive)



NEW Health Insurance Marketplace Coverage Options and Your Health Coverage

New Health Insurance Marketplace Coverage Options and Your Health Coverage (Non tax levy)

City Health Plans Dependent Eligibility Verification Audit
Dependent Eligibility Verification Audit FAQs

Important Pension Information – New Tier VI in effect April 1, 2012

COBRA Information/Continued Coverage Application

Important Phone Numbers


Classified Staff Contact Sheet

Instructional Staff or Non Instructional Staff Contact Sheet

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