Medical and Prescription Drug Plan Options

Syracuse University offers the following medical and prescription drug plan options to all benefits-eligible employees:

  • SUBlue
  • SUOrange
  • SUPro

All three plan options include medical benefits administered by POMCO and prescription drug benefits administered by OptumRx. Note: Prior to January 1, 2016, Express Scripts (formerly known as Medco) administered prescription drug benefits.

Contact POMCO Member Services toll-free at 877.GO1.SU44 (877.461.7844) or log into your secure member website at mypomco.com.

Plan Design

In general, the same services are covered under SUBlue, SUOrange and SUPro but with different payment structures. A summary of the three plans is provided in At a Glance: A Comparison of Health Care Plans.

More comprehensive reviews of the cost sharing required for services under the plans are provided in the Schedule of Benefits. In addition, should you wish to review the Medical Benefits Summary Plan Description (SPD) or the Medical Benefits Booklet, these can be found on MySlice under Employee Resources.

The following table highlights some key differences among the plans:

SUBlue SUOrange SUPro
Network Coverage Provides in-network and out-of-network coverage Provides in-network coverage only Provides in-network and out-of-network coverage
Referrals Necessary for maximum (Level 1) benefits Necessary Not necessary
Cost Sharing
(in- network – Level 1 benefits)
Generally copays Generally copays Generally deductible and coinsurance

The following online tools are available (see “Helpful Links” below) to help employees determine which plan will be most effective for their needs:

  • Online summaries with detailed coverage information for SUBlue, SUOrange, and SUPro.
  • A sample POMCO Explanation of Benefits (EOB) to help you navigate the layout and codes of this document. Reviewing your EOB documents (you can find online on the POMCO web site) may help you evaluate which plan option is best for you.
Participating Provider Network

The level of medical coverage you receive for medical services is based on whether your physician participates in the POMCO-PHCS/Multiplan network. You should confirm that your medical providers are in the network. If your provider does not participate and you would like POMCO to attempt to recruit him or her, please contact POMCO Member Services at 877-461-7844.

Contributions

SU pays most of the cost of your medical coverage and you pay the remaining cost of the premium through pre-tax payroll deduction. Benefits-eligible employees default into the Schedule A contribution rates for medical coverage unless they qualify, apply and are approved for Schedule B contributions. Graduate Assistants are automatically defaulted to Schedule B contributions.

Premiums for domestic partners and their children are paid on an after-tax basis.

Contributions listed below are based on the 12-month calendar year. Actual deductions from each paycheck will vary depending upon your deduction cycle.

Medical Contribution Rates for 2016*

2016 Medical Rates

Helpful Links

Plan Designs


POMCO:  For assistance, call toll-free 877.GO1.SU44 (877.461.7844)

 

Online Tools

Marketplace Coverage Notice

Questions? Contact the HR Service Center at 315-443-4042 or e-mail hrservic@syr.edu.

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The web pages summarize your Syracuse University benefit options. Every effort has been made to ensure this information is accurate. However, the programs are governed by legal documents and insurance contracts. If there is any difference between the information on these web pages and the official documents and contracts, the official documents and contracts will rule. Our benefits are governed by current laws and operated according to Internal Revenue Service (IRS) regulations. We will notify you if changes in plans are necessary to comply with the law or with IRS regulations.

Employees electing to participate in the SU benefit plans are bound by the terms of the governing Plan documents. If you have any questions regarding the plans, you may request a copy of the Plan document from the Plan Administrator by contacting the HR Service Center at the number indicated at the end of this page.

As is the case with all benefits offered by SU, (1) the Plan Administrator has the discretionary authority to interpret the terms of the Plan and such interpretation will be binding on all interested parties to the fullest extent permitted by law, and (2) the University reserves the right to modify or terminate the Plan at any time.