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.
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|
The University is proud to include coverage for the following treatments and services:
- Hearing Aids: 50% of the allowed charge, up to $750 per hearing aid
- Chiropractic Care: spinal manipulation and related x-rays
- Acupuncture: for palliative pain relief when rendered by a certified acupuncturist
- Transgender Healthcare: services for gender confirming surgery and reconstructive services, transition-related mental health care and hormone therapy
- International Claims: eligible for in-network/Level One benefits under the SUBlue and SUPro plans, including routine/non-urgent care received when traveling for work or personal business (not available in SUOrange)
Referrals and/or pre-certification may be required; refer to the plan documents or contact POMCO for more information.
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 before each visit, because the network is subject to change. 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 2017*
- 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)
- Summary of Benefits and Coverage (SBC)
- MyPOMCO – Access your secure account
- How to set up your personal MyPOMCO account
- How to view your covered dependents’ information in MyPOMCO
- MyPOMCO mobile app for iPhone and Android
- POMCO Participating Providers
- POMCO Health Reimbursement Form
- US Imaging – VIP appointment services for MRI, PET and CT scans
- POMCO In-Network Immunization Providers
Marketplace Coverage Notice
Questions? Contact the HR Service Center at 315-443-4042 or e-mail firstname.lastname@example.org.
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.