2017RETIREE NEWS
FOR RETIREES WHO RETIRED ON OR AFTER JAN. 1, 2006
2018 BENEFITS NEWS
Welcome to the 2017 edition of Retiree News, created to inform you about your health plan coverage through Syracuse University for 2018.
We are committed to providing an excellent set of health
benefits to protect both the physical and financial well-being of
you and your family. The medical plan 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 to those who are eligible.
• 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/2017-open-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 on
page 2 of this newsletter.
• 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 6 for additional information.
• If you want to stay with the medical plan—SUBlue,
SUOrange, or SUPro—that you are currently enrolled in, you
do not need to take any action other than respond to the
retiree billing information you receive from Lifetime Benefit
Solutions.
• If you want to enroll or switch health plans, you are eligible to
do so during this year’s Open Enrollment period for retirees.
To make changes, please contact Lifetime Benefit Solutions
now through Nov. 30 at 800.493.0318 option # 3.
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, we offer those who retired after Jan. 1, 2006, and their
eligible dependents the choice of three medical plan options: SUBlue,
SUOrange, and SUPro. All plan options include medical benefits
administered by Excellus BCBS, and prescription drug benefits (for those
who are eligible) administered by OptumRx. In general, the same services
are covered under both 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 covers
only in-network services. SUOrange does not provide out-ofnetwork
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, diagnostic
machine 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 Benefits available online openenrollment.syr.edu/2017-openenrollment-
overview/retiree-and-cobra-news/, along with a frequently ask questions resource guide that applies specifically to
COBRA and retiree 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).
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 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 #3 with any retiree
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.
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 Excellus BCBS Nurse line
800.493.0318
(TDD/TTY: 800.662.1220)
ENHANCED VACCINATION OPTIONS
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.
Prescription drug coverage may not be applicable for all retirees. If you are not eligible for prescription drug coverage through the
University, please disregard all references to OptumRx.
STAY HEALTHY and GET VACCINATED
SEPT.–DEC. 31, 2017
Use your OptumRx member I.D. card 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 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 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.
RETIREE MEDICAL RATES
The following table summarizes the contributions required for individuals in the SUBlue, SUOrange, and SUPro plans.
2018 MONTLY HEALTH PLAN RATES FOR RETIREES WHO RETIRED ON OR AFTER 1/1/06*
Years of Service After Age 45
1-9 Years
SUBlue
Pre-65 Adult: $933.29
Post-65 Adult: $151.81
SUOrange
Pre-65 Adult: $907.16
Post-65 Adult: $146.57
SUPro
Pre-65 Adult: $950.33
Post-65 Adult: $144.62
10 Years
SUBlue
Pre-65 Adult: $672.61
Post-65 Adult: $107.02
SUOrange
Pre-65 Adult: $681.36
Post-65 Adult: $109.15
SUPro
Pre-65 Adult: $691.20
Post-65 Adult: $101.23
11 Years
SUBlue
Pre-65 Adult: $642.20
Post-65 Adult: $101.80
SUOrange
Pre-65 Adult: $655.02
Post-65 Adult: $104.78
SUPro
Pre-65 Adult: $660.97
Post-65 Adult: $96.17
12 Years
SUBlue
Pre-65 Adult: $611.78
Post-65 Adult: $96.57
SUOrange
Pre-65 Adult: $628.67
Post-65 Adult: $100.42
SUPro
Pre-65 Adult: $630.74
Post-65 Adult: $91.11
13 Years
SUBlue
Pre-65 Adult: $581.37
Post-65 Adult: $91.35
SUOrange
Pre-65 Adult: $602.33
Post-65 Adult: $96.05
SUPro
Pre-65 Adult: $600.51
Post-65 Adult: $86.05
14 Years
SUBlue
Pre-65 Adult: $550.96
Post-65 Adult: $86.12
SUOrange
Pre-65 Adult: $575.99
Post-65 Adult: $91.68
SUPro
Pre-65 Adult: $570.28
Post-65 Adult: $80.99
15 Years
SUBlue
Pre-65 Adult: $520.54
Post-65 Adult: $80.90
SUOrange
Pre-65 Adult: $549.64
Post-65 Adult: $87.32
SUPro
Pre-65 Adult: $540.04
Post-65 Adult: $75.93
16 Years
SUBlue
Pre-65 Adult: $490.13
Post-65 Adult: $75.67
SUOrange
Pre-65 Adult: $523.30
Post-65 Adult: $82.95
SUPro
Pre-65 Adult: $509.81
Post-65 Adult: $70.86
17 Years
SUBlue
Pre-65 Adult: $459.72
Post-65 Adult: $70.45
SUOrange
Pre-65 Adult: $496.95
Post-65 Adult: $78.59
SUPro
Pre-65 Adult: $479.58
Post-65 Adult: $65.80
18 Years
SUBlue
Pre-65 Adult: $429.30
Post-65 Adult: $65.22
SUOrange
Pre-65 Adult: $470.61
Post-65 Adult: $74.22
SUPro
Pre-65 Adult: $449.35
Post-65 Adult: $60.74
19 Years
SUBlue
Pre-65 Adult: $398.89
Post-65 Adult: $60.00
SUOrange
Pre-65 Adult: $444.27
Post-65 Adult: $69.85
SUPro
Pre-65 Adult: $419.12
Post-65 Adult: $55.68
20+ Years
SUBlue
Pre-65 Adult: $368.48
Post-65 Adult: $54.77
SUOrange
Pre-65 Adult: $417.92
Post-65 Adult: $65.49
SUPro
Pre-65 Adult: $388.89
Post-65 Adult: $50.62
* A monthly administrative fee will apply.
Please keep in mind that the University’s plan does not include prescription drug coverage for those who are Medicare eligible. We recommend
that you consider enrolling in a Medicare Part D prescription drug plan once you are eligible for Medicare, and that you make plans three months in advance to replace your SU prescription coverage when you lose it.
Remember, if you or any of your covered dependents are not yet 65 but are Medicare-eligible, you and/or they must enroll in Medicare Parts A and
B immediately and notify our medical plan administrator. Medicare integration applies to individuals eligible for Medicare whether or not they are enrolled in Medicare; if a Medicare-eligible individual decides not to enroll in Medicare, out-of-pocket costs for claims made under the plan are likely to be significantly higher. If you have questions about this, contact POMCO at 877.461.7844. Starting Jan. 1, 2018, contact Excellus BCBS
at 800.493.0318 (TDD/TTY: 800.662.1220).
THE HEALTH PLANS AND THE MARKETPLACE
All three retiree health plans, SUBlue, SUOrange, and SUPro, meet
the coverage and affordability requirements of the Affordable Care
Act. This means that if you or your dependents are enrolled in any
of these plans, or public programs such as Medicare or Medicaid,
you meet the individual mandate requiring everyone to have
health insurance. However, given the variety of health insurance
options available through the Marketplace of private insurers
and the subsidies available, you may want to consider whether
private insurance is a good option for you and your dependents.
More information on the Marketplace is available by phone at
800.318.2596 (Federal) and 855.355.5777 (New York State), and
online at (Federal) or nystateofhealth.ny.gov/
(New York State). You should also compare the coverage and cost of
these plans with those available to you through a spouse or domestic
partner.
Remember, the University offers an Opt Out/Opt In provision to
individuals who are eligible for subsidized retiree health care coverage
through the University. This provision gives you the ability to waive
out of the retiree health plans with the option to opt back in at a later
date, as long as you have had continuous coverage or are Medicare
eligible. For more information on the Opt Out/Opt In provision and the
applicable eligibility rules, go online to hr.syr.edu/retiree-opt. If you have
any questions about opting out of an SU plan, you may contact the HR
Service Center at 315.443.4042 or .
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. An SBC summarizes important information about
health coverage in a standard format to help you compare features
across coverage options available to you. Please keep in mind that
the University’s SBCs are not specific to our retiree medical plans,
and therefore some benefits, such as prescription drug coverage,
may not be applicable. The SBCs for the SUBlue, SUOrange, and
SUPro coverage options are posted on this website: hr.syr.edu/sbc.
Paper copies of the SBCs also are available, and may be requested
at any time free of charge by contacting the HR Service Center at
315.443.4042 or .
TIME TO REVIEW DEPENDENT ELIGIBILITY
Open Enrollment is your time to review and remove any dependents you have on your plans who no longer meet the definition of eligible dependent.
To review the eligible dependent criteria, see the Benefits Eligibility
Policy (openenrollment.syr.edu/benefitseligibility).
DENTAL AND VISION PLAN
If you are enrolled in the University’s Dental and Vision coverage
under COBRA, there are no charges to the rates 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 year 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. Next year’s Open Enrollment
will provide you with the opportunity to change your plan coverage if
you are still enrolled. 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 COBRARATES
BASIC
Individual: $25.56
Individual + 1:$43.31
Family: $58.91
BASIC PLUS VISION
Individual:$30.44
Individual + 1:$54.28
Family:$69.88
COMPREHENSIVE
Individual:$31.56
Individual + 1:$48.14
Family:$66.72
COOMREHENSIVE PLUS VISION
Individual: $36.44
Individual + 1: $59.11
Family: $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