Forms & Benefits
Below you will find a myriad of resources available to APSCUF members. Included on this page is information relating to medical benefits (including claim forms, plan comparisons and much more), retirement planning, Healthy U, members-only special services and discount programs, coaches supplemental benefits, and much more. Click here to download a PDF file outlining the benefits of your APSCUF membership.
Not a member? Learn more about joining APSCUF. If you are a member and have any questions about any of these benefits or services, please contact Nancy Koutris at 800-932-0587, ext. 3021, or email her at firstname.lastname@example.org.
FLU SHOTS 2018–19
- Flu Shot Opportunities – 2018
- Highmark Contracted Pharmacy Vaccination List – August 2018
- UPMC HMO Flu Shot Reimbursement Form
GENERAL BENEFIT INFORMATION
- Benefit summary for faculty and coaches (PDF)
- Benefit highlights for faculty and coaches (PDF)
- Hearing benefit
- Employee Health Contribution Schedule
PA FACULTY HEALTH AND WELFARE FUND
The pafac.com website is experiencing difficulties, and we are working to resolve them. Please use the PDF forms below.
- Maintain your eyes and teeth this summer (June 2016)
- Revisions and benefit announcements (December 2015)
- Health & Welfare Fund Website
- Health & Welfare Fund: Extension of Coverage for Adult Children (PDF)
- Health & Welfare Fund: Annual Vision Benefits (PDF)
- Part-time Faculty Claim Form (PDF)
- Electronic submission of dental claims (PDF)
- Dental Claim Form (PDF)
- Vision Claim Form (PDF)
COACHES SUPPLEMENTAL BENEFITS
- State System dental benefits program
- United Concordia claim form
- United Concordia claim-form instructions
- NVA Vision benefit summary
- NVA Vision
- PPO handbook
- PPO highlights
- PPO preventive schedule
- Member-submitted Highmark claim form (fillable PDF)
- BCBS Global Core claim form (international medical claims)
- BCBS Global Core brochure (international medical claims)
HIGHMARK PRESCRIPTION DRUG PLAN
- Prescription Drug Program Summary – Effective Jan. 1, 2017
- Pharmacy benefits FAQs
- Express Scripts mail-order form
- Revised process for prescription drug overrides
- Changes to the Rx plan for faculty and coaches (intro, managed prescription drug coverage) – Effective July 1, 2017
- Changes to the Rx plan for faculty and coaches (prior authorization, step edit program, Walgreens specialty pharmacy) – Effective July 1, 2017
HIGHMARK WELLNESS PROGRAMS
- Flexible Spending Accounts
Effective January 2015, ADP will provide the administration for the Flexible Spending Account Program. You can find more about this change here.
- Pre-retirement checklist
- Retirement system and plan websites and detailed contact information
- Additional retirement information, including PASSHE information
- Already retired? Check out our APSCURF section for more information.
FACULTY AND COACHES INTERNSHIP
APSCUF’s faculty and coaches orientation internship is for APSCUF members who have some local APSCUF responsibility and are interested in expanding a working knowledge of the union. Interns spend a week in the summer in the Harrisburg office to observe the entire spectrum of union administration. They interact with staff members who serve in various capacities. The program aims to prepare APSCUF members for increased local and/or state responsibilities. Click here to download an application and more information about hotels, travel, and meals. Questions? Email Andrea Mahoney at email@example.com.
Don't miss any of your member benefits! Click here to download a PDF file outlining the benefits of your APSCUF membership.