Syracuse University offers three medical and prescription drug plan options to all benefits-eligible employees. 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.
The three plan options available are:
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:
|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|
(in- network – Level 1 benefits)
|Generally copays||Generally copays||Generally deductible and coinsurance|
Among the provisions of the Patient Protection and Affordable Care Act is expanded coverage for preventive care services. Many common preventive care services are covered at no cost to the member. For a list of covered services, please see www.HealthCare.gov/center/regulations/prevention.html. These new standards will apply to In-Network services only, unless specified otherwise in the Schedule of Benefits. Frequency and age limitations may apply.
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.
SU pays a significant portion 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*
- Benefits Eligibility Policy (Including information about coverage for dependents up to age 26 and Opposite Sex Domestic Partner coverage)
- Schedule B Medical Contributions (Eligibility and Application Information)
- 2016 Summary of Benefits and Coverage SUBlue
- 2016 Summary of Benefits and Coverage SUOrange
- 2016 Summary of Benefits and Coverage SUPro
- POMCO – Access my personal secure MyPOMCO account
- POMCO Health Reimbursement Form
- MyPOMCO – Instructions on how to create a Personal Account and view your personal benefit information through POMCO’s secure website
- MyPOMCO – Instructions to have your covered dependents create personal accounts and how they can grant you access to view their information
- POMCO Participating Providers
- US Imaging – VIP appointment services for MRI, PET and CT scans
- POMCO Group In-Network Shot Providers
Marketplace Coverage Notice
Questions? Contact the HR Service Center at 315-443-4042 or e-mail email@example.com.
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.