RETIRED MEMBERS
SUPERIOR OFFICERS COUNCIL
RETIREES - HEALTH & WELFARE FUND
SCHEDULE OF BENEFITS 01/1/06

1. DEATH BENEFIT
Covers Retiree only - $5,000 payable to designated beneficiary

2. DENTAL PROGRAM
Covers retiree, spouse or qualified domestic partner, dependent children to age 19 and full-time student dependents 19-23. The member has a choice of three (3) dental plans: 1. Indemnity (fee schedule and choice of own dentist. 2. One comprehensive plan in the New York and outlying areas. Most services covered in full with co-payments in prosthetics, endodontics and anesthesia, no dental forms and assigned dentists. And (3) American Dental plans in Florida only a comprehensive program same as 2. Note-- No Orthodontia coverage is provided ( DENTALL NOT OPEN TO NEW SUBSCRIBERS)

3. OPTICAL BENEFIT
Covers retiree, spouse or qualified domestic partner and effective January 1, 1996 dependent children to age 19 and full time student dependents 19-23. Provides an eye examination and one pair of eyeglasses for the member and spouse every two (2) years and dependents each year.

4. 365 DAY HOSPITAL RIDER
All retirees, spouse or qualified domestic partner are covered either under the basic plan or by a rider purchased by the S.O.C.

5. PRESCRIPTION DRUGS

All subscribers except HIP Members.- Covers retiree ,spouse or qualified domestic partner only. There is a annual $150 FAMILY deductible that must be satisfied beginning each January. The Fund provides a prescription drug program for drugs purchased at your pharmacy and through our mail order program. If drugs are purchased at your pharmacy, members will be charged $5 for all prescriptions, up to $25. Drugs costing over $25 require a co-payment of 30%. (Fund pays 70% and member 30%). Ours is a MANDATORY GENERIC PROGRAM with a $7,000 Annual Cap per family. The Maintenance (MAIL ORDER) Program allows for a 6 month supply ( 90 day supply plus one refill ) with a $10 co-payment for each 90 day prescription costing under $100. Drugs costing over $100, in the maintenance mail-order program, will require a 30% Co-Pay with maximum out of pocket cost of $250 for each 90 day supply.

P. I. C. A. Drug coverage--- (NON-MEDICARE) Effective July 1, 2005. Injectables and Chemotherapy medications will continue to be covered through the PICA program and be administered by NPA. Continue to use the same prescription drug card you have been using to fill these prescriptions. Psychotropic and Asthma medication will no longer be available through the PICA program. These two medications will be obtained through our Health & Welfare drug program. If you encounter a problem the pharmacist should call NPA’s Customer Service at 1 800-467-2006.

All other drugs, except diabetes medication, can be obtained through the SOC prescription drug program as described above. Diabetes medication must be obtained through the member’s underlying health care plan (example GHI, HIP, Aetna, etc.)

MEDICARE ELIGIBLE RETIREES must continue to have prescriptions filled for themselves, their spouses and/or domestic partners, through the same manner as before either through the SOC Prescription Drug Program or the HIP drug rider if enrolled in HIP. Diabetic Medication, for Medicare eligible retirees, is also obtained in this manner.

6. HEALTH RIDER REIMBURSEMENT BENEFIT

HIP SUBSCRIBERS ONLY - Covers retiree, spouse or qualified domestic partner and dependent children. Provides prescription drugs, private duty nursing and appliances. The Fund reimburses a maximum of $350 per year payable in the following year for the rider deducted from the Retirees pension check. HIP retirees must take the high option rider which provides them with a drug card.

7. SOC CATASTROPHIC RIDER
Covers retiree, spouse or qualified domestic partner and dependent
Children full time students 19-23.
After a $4,000 annual family deductible, GHI pays 100% of reasonable and customary charges based on a current profile with a maximum lifetime up to $250,000 per person. Limitations: Private Duty Nursing Care - first $25,000 paid, thereafter 50% of the remainder with a lifetime cap of $50,000 and Mental Health - $10,000 individual lifetime maximum for in hospital mental health charges.

8. SOC CATASTROPHIC $1,000 REIMBURSEMENT BENEFIT
Covers retiree, spouse or qualified domestic partner and dependent
Children full time students 19-23.
A self-funded $1,000 direct reimbursement benefit is provided and payable to the member upon attaining $4,000 out-of-pocket eligible incurred expenses for services rendered on and after January 1, 1996. Eligible out-of-pocket expenses are those medical and hospital charges that are considered reasonable and customary by the Plan and not fully reimbursed by the City Health Plan or private group insurers. The exclusions and restrictions are the same as the requirements for the Catastrophic Coverage Benefit.

9 HEARING AIDS
Retired members and their dependents are NOT eligible for hearing aids.

10 ANNUITY TRUST FUND INFORMATION FOR AFFILIATED PARTICIPANTS
Upon retirement each member is forwarded an Annuity Trust Fund Form with options and a letter detailing the options. In selecting continued participation it is necessary to return the Annuity Form selecting this option. If the form is not returned the individual monies will automatically be withdrawn and a 20% Federal Income Tax withheld. If your request to continue participation is accepted by the Plan Trustees, your Accumulated Share will continue to be invested in the same risk/reward ratio as all other participants to age 70. City contributions will terminate upon retirement. Voluntary contributions are not permitted.