Cancer Copay Fund for Employees of Clarendon College

DONATION FORM

NAME OF FUND:  The PAC Fund (Paws Against Cancer Fund)

      

PURPOSE OF FUND

          The PAC Fund is designed to enhance and improve employee morale by assisting full-time faculty and staff employed on any of the campuses of the Clarendon College system in meeting the financial strain of cancer treatments by helping with copay obligations.  This assistance helps employees afford the out-of-pocket copay costs for treatments related to any kind of cancer that the college health insurance company covers.  Treatments include, but are not limited to, chemotherapy, hormone therapy, immunotherapy, radiation therapy, surgery, stem cell transplant, and targeted therapy. 

 

GUIDELINES FOR THE FUND

• The PAC Fund is donor-funded.
• The PAC Fund will be managed as an Agency Fund.
• Persons eligible to apply are faculty and staff who are employed full-time by any of the campuses in the Clarendon college system.
• All recipients must be on the health insurance plan chosen by Clarendon College.
• Recipients must submit a copy of the Explanation of Benefits (EOB) when requesting a copay reimbursement.
• Requests are to be written in a simple, straightforward manner.
• Each recipient is limited to three requests per semester and one per each summer term.
• The recipient must use the assistance for the purpose intended within their request.
• Individuals with supplement health insurance plans are not eligible for this assistance.
• A general report about the fund shall be made each fall at the beginning of the Fall term.
• A standing PAC committee will receive copay requests and make final decisions about eligibility and amount.The Committee will consist of a minimum of four full-time faculty and staff, one from each college campus. Care will be taken to ensure major groups are represented:one faculty, one Dean, one operational staff, and one support staff.
• Funds will be available for reimbursement beginning January 1, 2023.