2017 Open Enrollment
FOR COBRA PARTICIPANTS
2018 Benefits news
Open Enrollment is your opportunity to review and update your
benefit choices for the coming year. Take action now through Nov. 30
if you wish to make any changes to your benefits for 2018. Highlights
for next year include the following:
• Effective Jan. 1, 2018, Excellus BlueCross BlueShield (Excellus
BCBS) will be the medical plan administrator and Lifetime Benefit
Solutions will be the retiree/COBRA billing administrator, replacing
POMCO. OptumRx will continue to provide prescription drug
coverage.
• Members enrolled in SUBlue and SUOrange will no longer be
required to obtain referrals to see in-network providers.
• Copays for certain medical services will increase by $10. This is the
first increase in four years. An annual in-network deductible will be
applied to SUBlue and SUOrange. All copays and deductibles are
listed on the University’s website, openenrollment.syr.edu/2017open-
enrollment-overview/retiree-and-cobra-news/.
• There will be no changes to existing deductibles or coinsurance for
SUPro. SUPro has no referral requirement.
• Shortly, you will receive information in the mail from Excellus BCBS
and Lifetime Benefit Solutions. If you are enrolled in medical as
of Jan. 1, 2018, the information you receive from Excellus BCBS
will include your new insurance card. The information you receive
from Lifetime Benefit Solutions will explain their billing process.
The contact information for Excellus BCBS and Lifetime Benefit
Solutions is provided below.
• Delta Dental is changing the frequency of dental cleanings from
two per 12-month period to two per calendar year. This means
that no matter when you had your last cleaning in 2017, you will
have access to two cleanings in calendar year 2018. See page 4 for
additional information.
• If you want to make any changes to your current coverage, please
contact Lifetime Benefit Solutions now through Nov. 30 at
800.493.0318 (TTY/TTD: 800.662.1220) option # 4.
We encourage you to review your current benefits, consider your
options, and make the choices that best serve you and your family.
Open Enrollment is the one time each year you may make changes to
your benefit elections, unless you undergo a change in family status
such as marriage, divorce, the birth or adoption of a child, or if you lose
your insurance coverage or experience another “qualifying life event”
in 2018.
Learn More About Excellus BCBs
Now through Jan. 1, 2018:
• Confirm your providers are in Excellus’ network:
openenrollment.syr.edu/excellus-bcbs-provider-directory.
• Take the opportunity to speak with an Excellus BCBS
representative one on one during the on-campus office hours.
See the schedule posted online openenrollment.syr.edu/wp-
content/uploads/2017/10/Excellus-Office-Hours_final.pdf.
• Call our dedicated Excellus BCBS customer service center
at 800.493.0318 (TTY/TTD: 800.662.1220) if you need
additional assistance regarding your personal medical questions.
Excellus BCBS has expanded hours of operation: Monday –
Thursday: 8 a.m.-8 p.m. Friday: 9 a.m.–8 p.m.
• Call our dedicated Lifetime Benefit Solutions customer service
center at 800.493.0318 option #4 with any COBRA billing
questions. Lifetime Benefit Solutions is a subsidiary of Excellus
BCBS with offices in Liverpool, New York. The hours of operation
are Monday-Thursday: 8 a.m.-5 p.m. Friday: 9 a.m.-5 p.m.
Introducing Excellus BlueCross BlueShield
Beginning Jan. 1, 2018, Excellus BCBS will replace POMCO as
the administrator for all Syracuse University medical plans. As an
Upstate New York-based provider with offices in DeWitt, Excellus
BlueCross BlueShield was selected because of its many strengths and
capabilities, including its comprehensive health management programs
to ensure exceptional patient care and commitment to providing the
highest level of customer service to our members.
Excellus BCBS will hold on-campus office hours twice per week during
Open Enrollment and into 2018. An experienced representative from
Excellus will be available to assist members with any personal health
questions. We encourage everyone to take the opportunity to speak
with an Excellus BCBS representative one on one during the on-
campus office hours. A schedule is posted online openenrollment.syr.
edu/wp-content/uploads/2017/10/Excellus-Office-Hours_final.pdf.
Registration is not required.
Medical Plan Changes
As in the past, COBRA participants have the choice of three health
plans: SUBlue, SUOrange, and SUPro. All three plan options include
medical benefits administered by Excellus BCBS, and prescription
drug benefits administered by OptumRx. In general, the same services
are covered under all three plans, but with a different deductible and
copay/coinsurance structure.
SUBlue and SUOrange will be modified in the following three ways as
of Jan. 1, 2018 (there are no changes to the SUPro plan):
1. Referrals will no longer be required to see a provider to receive in-
network benefits. Services will either be covered as in-network or
out-of-network under SUBlue. It’s important to note that SUBlue
and SUPro offer out-of-network coverage, while SUOrange generally covers only in-network services. SUOrange does not provide out-of-network coverage except in limited emergency situations. Our partnership with Excellus BCBS provides members with access to in-network doctors and hospitals in 200 countries
worldwide—providing you and your loved ones with financial security when traveling abroad.
2. While the University has successfully held copays steady for
the last four years, in order to continue to manage our costs and
offer comprehensive health management programs, services that
currently require a member copay of $20, $25, or $40 will increase
by $10. These include services such as office visits, diagnosticmachine tests, physical therapy, and chiropractic care. All other services will remain at the copays in place for 2017.
3. There will now be an annual deductible of $100 per individual with a
maximum of $250 for a family for in-network services. A deductible is a dollar amount members pay toward covered medical care each year, before their health plan begins to pay for covered medical expenses. Once the annual deductible has been met, additional in-network services for the remainder of the year will be covered at the copay and/or coinsurance percentage that applies to that service.
All copays and deductibles are listed in the Schedule of Benefitsavailable online openenrollment.syr.edu/2017-open-enrollmentoverview/retiree-and-cobra-news/, along with a frequently asked questions resource guide that applies specifically to retiree and COBRA participants.
Provider Directory
With the change to Excellus BCBS in 2018, the network of
participating providers will change. While Excellus BCBS offers
access to the largest nationwide provider network, you should
confirm your providers participate with the network. Visit our website
openenrollment.syr.edu/excellus-bcbs-provider-directory/ to search
Excellus’ provider directory.
New I.D. Cards
If you are enrolled in medical as of Jan. 1, 2018, you will receive a
new Excellus BCBS I.D. card in mid-December at your home address.
Please be sure to use this new card, beginning Jan. 1, 2018, the next
time you visit your provider. If you don’t receive your I.D. card in the
mail, contact our dedicated Excellus BCBS customer service center at
800.493.0318 (TTY/TTD: 800.662.1220).
Nurse-Line Available 24/7
With Excellus BCBS, medical plan participants can contact a nurse by
phone anytime—24 hours a day, seven days a week. Excellus BCBS
specially trained registered nurses can provide support and education for
members with chronic or complex health conditions, or provide answers
to more general health questions. Key features of the nurse line include:
• Decision-making support and education when you need it most
• Triage to appropriate level of care
• Information regarding diagnoses, medications, and treatment options
• Assistance with finding providers
• Nutritional information
Health Questions? Ask A Nurse Today!
Call the excellus BCBs nurse line 800.493.0318 (ttY/ttD: 800.662.1220)
EnhancedVaccinationOptions
Annual vaccination is an important step you can take to protect yourself and others from the flu. Get your flu shot and other covered vaccines at more
than 68,000 participating pharmacies with $0 copay when you utilize your OptumRx member I.D. card. For vaccines not provided through a pharmacy,
you may continue to obtain covered vaccines through your doctor’s office using your medical plan I.D. card.
STAY HEALTHY and GET VACCINATED
SEPT.–DEC. 31, 2017
Use your OptumRx member I.D. card at a participating pharmacy for $0 copay.
For Vaccines Not Covered through a Pharmacy
You and your eligible dependents may continueto obtain covered vaccines through your doctor’s office using your POMCO I.D. card.
BEGINNING JAN. 1, 2018
For maximum flexibility, you may use either your OptumRx or your Excellus BCBS member I.D. card when receiving covered vaccines at a
participating pharmacy to receive covered vaccines for $0 copay.
For Vaccines Not Covered through a Pharmacy
You and your eligible dependents may continue to obtain covered vaccines through your doctor’s office using your Excellus BCBS I.D. card.
Vaccines Currently Provided through Pharmacies in New York State*
Flu, pneumonia, Tdap (Tetanus, Diphtheria, and Pertussis), meningococcal and shingles vaccines are eligible for individuals over the age of 18.
*Contact your local pharmacy to determine your state’s coverage options.
If you have questions about covered vaccines not provided through a pharmacy, please contact our medical plan administrator.
Medical Plan Rates
2018 Monthly Health Plan COBRA Rates
Health Plans
Individual Only
SUBlue:$575.15
SUOrange:$559.10
SUPro:$538.41
Individual + Spouse/Domestic Partner
SUBlue:$1,265.29
SUOrange:$1,229.79
SUPro:$1,184.51
Individual + Child(ren)
SUBlue:$1,110.03
SUOrange:$1,078.85
SUPro:$1,039.13
Individual + Spouse/Domestic Partner + Child(ren)
SUBlue:$1,800.19
SUOrange:$1,749.66
SUPro:$1,685.21
Comparison Made Easy
Choosing health coverage is an important decision. To help you make
an informed choice, a Summary of Benefits and Coverage (SBC) is
available to you. The SBC summarizes important information about
health coverage in a standard format to help you compare features
across coverage options available to you. The SBCs for the SUBlue,
SUOrange, and SUPro health plans are posted on the following website:
hr.syr.edu/sbc , under Helpful Links/Plan Designs.
If you would like to receive a printed copy free of charge, please contact
Human Resources at 315.443.4042 or .
Dentaland Vision Plan
There are no changes to the rates for the University’s dental and vision plans for 2018.
New for 2018, Delta Dental is changing the frequency of dental cleanings from two per 12-month period to two per calendar year. This means that no matter when you had your last cleaning in 2017, you will have access to two cleanings in calendar year 2018.
This is the second of the two-year enrollment cycle, which means you are not able to enroll or change plan options, but you may add or remove a dependent from your coverage if you are still enrolled. Next year’s Open Enrollment will provide you with the opportunity to change your plan coverage. Dental and vision benefit summaries are available online hr.syr.edu/dental.
If you are enrolled in the SEBF dental/vision plan under COBRA, you may maintain or change your SEBF coverage. Contact SEBF at 855.835.9720 if you would like to make changes, or if you have specific questions regarding the plans.
2018 Monthly SEBF Dental/Vision COBRA Rates
Individual
Basic:$25.56
Basic Plus Vision:$30.44
Comprehensive:$31.56
Comprehensive Plus Vision:$36.44
Individual + 1
Basic:$43.31
Basic Plus Vision:$54.28
Comprehensive:$48.14
Comprehensive Plus Vision:$59.11
Family
Basic:$58.91
Basic Plus Vision:$69.88
Comprehensive:$66.72
Comprehensive Plus Vision:$77.69
Legal Notifications
Notice regarding the Syracuse University Group Health Plans notice of Privacy Practices
The Syracuse University Group Health Plans Notice of Privacy Practices (NPP) summarizes the privacy practices of Syracuse University’s group health plans. You have the right to receive a copy of the NPP (either electronically or a paper copy) at any time. Even if you have previously agreed to receive the NPP electronically, you are entitled to a paper copy of the NPP. You may review or print out a copy of the NPP online at supolicies.syr.edu/emp_ben/hipaa.htm. You may also contact the HR Service Center at 315.443.4042 for a paper copy.
Notice regarding the women’s Health and Cancer rights Act of 1998
The medical plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services, including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema. Call POMCO at 877.461.7844 for more information. Starting Jan. 1, 2018, contact Excellus BCBS at 800.493.0318 (TTY/TTD: 800.662.1220).
Every effort has been made to ensure the information in this newsletter is accurate. However, the benefits are governed by legal documents (which, in certain circumstances, may include insurance contracts). If there is any difference between the information in this newsletter and the official documents, the official documents will control. We reserve the right to modify or terminate these benefits at any time.
Contact Us
Questions about your benefits?
You can get the answers by contacting the HR Service Center at 315.443.4042 or .
Questions regarding enrollment and billing should be directed to Lifetime Benefit Solutions at 800.493.0318 option # 4.