Benefits: Open Enrollment

Medical and Prescription Drug Plan Options

SU 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 Medco.

There are no significant changes to the medical plan options this year.

Important Information Before You Enroll

Plan Design

In general, the same services are covered under SUBlue, SUOrange and SUPro but with different payment structures.

A quick one-page summary of the three plans is provided in Medical and Prescription Drug Plans – At A Glance.
More comprehensive reviews of the cost sharing required for services under the plans are provided in the Medical Comparison Chart - SUBlue and SUOrange and the Medical Comparison Chart - SU Pro.
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

To further help you determine which plan will be most effective for you, consider the following:

If you went to see a Provider this year, you received an Explanation of Benefits (EOB) in the mail from POMCO every time you utilized your medical benefit. The EOB details how your medical claims were paid. You can refer to your EOB’s to assist you in determining what your actual costs would have been under each of the plans.
If you didn’t keep your EOB’s, you can obtain your personal EOB’s online on the POMCO website. Create an account on the POMCO website so that you can access your personal benefit information in an easy and convenient way.
If you did not see a Provider this year, a sample EOB (SUBlue, SUOrange, and SUPro) is available to view in order to assist you in estimating costs under the SUPro plan.
View the Employee Expense Comparison to see examples of how services would be covered under each of the medical plans (SUBlue, SUOrange, and SUPro) to help determine if SUPro is the most effective plan for you.

Participating Provider Network

The level of medical coverage you receive from POMCO 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 complete the "Recruit a Physician" form on the POMCO website.

Prescription Drug Benefits

The prescription benefit has been improved this year with the introduction of RationalMed, a program in which Medco coordinates directly with your doctor if a medication you are prescribed has potential health and safety issues based on your other prescribed medications or medical conditions. There is no action for you to take to implement this service.
To encourage the use of generics, if a generic equivalent is available and you choose to have the brand name drug, or your doctor prescribes the script "Dispensed As Written" (DAW), you will be required to pay the difference between the actual cost of the brand name drug and the amount the plan would have paid for the generic equivalent.

SU Medical Aid Program (SUMAP)

The SU Medical Aid Program (SUMAP) provides additional assistance for qualifying employees in paying for some of their health care expenses. Benefits are determined based on number of applicants and available funding each year. Participants in 2009 had their medical out-of-pocket maximum reduced by 75% and some participants also had their premiums subsidized by 25%.

The application process for this program is separate from Open Enrollment. Please refer to the SUMAP website for more information.

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. Qualified same-sex domestic partner premiums are paid on an after-tax basis.

2010 Monthly Contributions*
SU Blue

SU Orange

SU Pro

Employee $ 81.12 $ 78.89 $ 73.98

Employee +1 $173.01 $168.25 $157.78

Family $225.45 $219.25 $205.61

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

Before you decide, consider the following:

Have you considered which of the three options, SUBlue, SUOrange, and SUPro is right for you and your family?
Do you have a regular physician or specialist? Is he or she in the POMCO-PHCS/Multiplan network?
If you have coverage from another source, is it enough to allow you to waive medical coverage from SU?
What medical coverage does your qualified spouse/same sex-domestic partner's employer provide? How does it compare in cost and coverage to SU's options?
What are your expected co-payments and coinsurance? Should you consider the Health Care Flexible Spending account to pay for these on a pre-tax basis?
Have you reviewed the SU Medical Aid Program (SUMAP) to see if you and your family qualify for extra assistance?

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The Open Enrollment webpages 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 webpages and the official documents and contracts, the official documents and contracts will rule. SU 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.

Helpful Links

Sample Explanation of Benefits (EOB)

Plan Designs

POMCO

POMCO-PCHS/Multiplan Network Participating Providers
POMCO - Recruit a Physician
POMCO - Create a Personal Account and view your personal benefit information

Medco

Need help? HR staff is available to assist you. Call the HR Service Center at 315-443-4042, or email hrservic@syr.edu.

2010 Monthly Contributions*	SU Blue	SU Orange	SU Pro
Employee	$ 81.12	$ 78.89	$ 73.98
Employee +1	$173.01	$168.25	$157.78
Family	$225.45	$219.25	$205.61