CCNY Benefits Forms
CCNY Benefits Forms
Updated Wednesday, April 8, 2015, 8:52AM
ADJUNCT HEALTH BENEFITS
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
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
If you are currently not covered or eligible to be covered by any other health insurance plan by
virtue of employment of self, 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 Benefits 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 health plans are available free of
charge, and dependent health insurance coverage is available through premium payment. For
detailed information, visit the UBO website, under Benefits at a Glance-> Adjuncts
Teaching and Non-Teaching.
Adjunct Health Benefits Forms
Full-Time Faculty and Staff Benefits Forms
Voluntary Retirement Forms
Full-Time Teaching and Non-Teaching Instructional Staff
Dedicated/Catastrophic Sick Leave Policy
Dedicated Annual/Sick Leave Program
Catastrophic Sick Leave Bank Program (CSLB)
(Application to Donate and Application to Receive)
Transit Benefit Forms
Effective March 22, 2015, an MTA approved fare hike of 25 cents, will go into effect. This will increase the base fare from $2.50 to $2.75 per ride, for the bus, subway and MTA Staten Island Railway. These increases will also affect the MetroCard 30-day unlimited, Pay Per Ride, Access-a-Ride, Long Island Railroad and the Metro-North Railroad. The new rate list can be found on the MTA Website. Please be advised; the monthly pre-tax limit is $130.00. Deductions that exceed this amount will be subject to taxes.
Employees who wish to adjust their deductions accordingly, enroll in the program, suspend their payroll deductions, or cancel their participation in the Commuter Benefits Program, can download, fill out and submit a WageWorks form to the HR Office, Shepard Hall, Room 50. Please be advised that changes to your WageWorks deductions may take up to 2 pay periods to take effect.
If you have any questions, please contact Kim Ferguson at 212-650-7963, or by email at email@example.com.
COBRA Information/Continued Coverage Application
(Please be advised that this form must be filled out by the Benefits Officer prior to submission. Please call x7963 for assistance with COBRA enrollment.)