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Management Benefits Fund
Superimposed Major Medical Plan


The Management Benefits Fund is pleased to offer supplemental (last-payer type) medical coverage to its members through its Superimposed Major Medical Plan (SMMP).

This plan supplements Basic City Health Insurance coverage by providing additional coverage to members who incur substantial qualifying out-of-pocket medical expenses that remain after all other health coverage has been applied. After an individual calendar year deductible is satisfied, the plan reimburses 90%* of non-reimbursed covered medical expenses at Reasonable and Customary (R&C) allowances until out-of-pocket expenses reach $2,500.

* Reimbursement is at 80% of R&C for out-of-pocket costs incurred for prescription drugs.

Summary of Benefits and Coverage (SBC)
Notice of Grandfathered Status
Learn more about Basic City Health Insurance

Please note that members covered under HMO plans are required to use the services of HMO providers and can only use the Fund's SMMP for co-payments or services not available under their HMO plan.

The SMMP also provides a hearing aid and audiometric examination benefit covering a maximum of up to $1,500 per hearing aid and 90% of Reasonable and Customary (R&C) allowances for audiometric examination. These benefits are not subject to the deductible.

Adult Wellness Benefit
The Adult Wellness Benefit covers annual and/or periodic physical and screening examinations that can result in early detection and intervention before a serious disease develops or advances. Some tests are age and gender-specific or related to health risk factors. Coverage is provided up to 100% of R&C and is not subject to the deductible.

The Plan is administered by Administrative Services Only, Inc. (ASO). For questions or inquiries on claims matters, a member may call ASO's customer service department toll-free at (877) 844-SMMP (877-844-7667).

Please refer to the Fund Booklet for complete details on the Superimposed Major Medical Plan.
See the SMMP FAQ
Download this section of the Fund Booklet (PDF)
Download the SMMP Claim Form (PDF)
Read the Management Benefits Voice Newsletter
Visit the ASO Web site

Spotlight

Employee Assistance Programs (EAPs)
EAPs are staffed by professional counselors who can help employees and their eligible dependents handle problems in areas such as stress, alcoholism, drug abuse, mental health, and family difficulties.

 Learn More
Quick Links

 PICA Program
 NYC Employee Blood Program
 Collective Bargaining Agreements
 OPA Web site
 NYC.gov