To get customized help on these topics, contact the HR Shared Services at 315.443.4042 or email@example.com.
If you do not wish to make any changes to your current health coverage, you do not need to take any action.
To make the following changes, please contact Lifetime Benefit Solutions, from Nov. 30-Dec.11:
- Retirees who retired before Jan. 1, 2006: If you wish to cancel your coverage because you have other coverage available to you that better meets your health care needs, contact Lifetime Benefit Solutions at 800.493.0318 (TTY: 800.662.1220).
- Retirees who retired on or after Jan. 1, 2006: If you want to enroll, cancel or switch health plans, contact Lifetime Benefit Solutions at 800.493.0318 (TTY: 800.662.1220). Remember, retirees who wish to enroll in coverage are subject to the Opt In/Opt Out provision.
- COBRA Participants: If you want to make changes to your enrollment, contact Lifetime Benefit Solutions at 800.493.0318 (TTY: 800.662.1220).
You will be able to learn more about Open Enrollment for retiree medical and COBRA participants by taking advantage of the following opportunities:
- Review the information designed specifically for retiree medical and COBRA participants within this website.
- Contact HR Shared Services at 315.443.4042 or firstname.lastname@example.org to speak with someone directly about your personal benefit questions. Virtual appointments are available as well and we are happy to find a time that best suits your needs.
- Call our dedicated Excellus BlueCross BlueShield (BCBS) customer service center at 800.493.0318 (TTY: 800.662.1220) if you need additional assistance regarding your personal medical plan questions. Excellus BCBS has expanded hours of operation Monday through Thursday from 8 a.m.-8 p.m. and Friday from 9 a.m.-8 p.m. With prescription drug questions, contact OptumRx member services at 866.854.2945 (TTY: 711). They are available to assist you 24/7.
- If you are eligible under COBRA for dental and vision, please contact Delta Dental at 800.932.0783 (TTY: 711) or VSP at 800.877.7195 (TTY: 800.428.4833) for vision plan questions.
The University offers three health plan options: SUBlue, SUOrange and SUPro. Please visit the health plan webpage for additional information on member cost sharing and plan design.
All three options include medical coverage administered by Excellus BCBS and prescription drug coverage through OptumRx. In general, the same services are covered under all three plans, but with a different deductible and copay/coinsurance structure. For 2021, there will be no increases in copays or coinsurance for SUBlue, SUOrange or SUPro. There will be a routine increase to the in-network deductibles for SUBlue and SUOrange of $50 for both individual and family coverage.
As of Jan. 1, 2021, the University’s health plan will change in the following ways, subject to applicable cost share:
- The University has previously covered all in-network preventive mammograms in full. As of Jan. 1, 2021, full coverage will be expanded to include all in-network preventive and diagnostic breast cancer screenings.
- COVID-19 testing will continue to be covered in full to ensure health plan members have access through the health plan.
- In response to the global health emergency, telemedicine and telehealth coverage was introduced to ensure members had access to care. These services will continue to be provided, including both provider-facilitated telemedicine coverage as well as telehealth through MDLIVE, at the equivalent cost sharing associated with in-person visits.
- OptumRx regularly evaluates and makes changes to the prescription drug formulary and programs that focus on safety and proper usage of certain prescriptions. If there are changes that may impact you, OptumRx will notify you prior to Jan. 1 with additional information.
Reference the Coverage Examples Guide [PDF] or the Schedule of Benefits documents to see, in general, how the deductible and copay/coinsurance are applied to certain services for SUBlue, SUOrange and SUPro.
Excellus BCBS has an expansive network and you will be able to access care within the U.S. and in many countries around the world through the BlueCard Program.
If you receive health care services from a participating Excellus BCBS Global Core provider, you can present your Excellus BCBS member ID card and pay the applicable deductible and copay/coinsurance under SUBlue, SUOrange or SUPro. If you are enrolled in SUBlue or SUPro and you see an international provider who does not participate in the BCBS Global Core network, you can submit those claims to Excellus BCBS for reimbursement as though the providers were participating; however, there is no coverage for non-participating providers in the SUOrange plan.
For 2021, there will be no increases in copays or coinsurance for SUBlue, SUOrange or SUPro. There will be a routine increase to the in-network deductibles for SUBlue and SUOrange of $50 for both individual and family coverage.
The following table highlights some key differences among the three plan options:
|Network coverage||Provides in-network and out-of-network coverage||Provides in-network coverage only||Provides in-network and out-of-network coverage|
|Referrals||Not required||Not required||Not required|
|Your cost when you use an in-network provider||Generally deductible and copays||Generally deductible and copays||Generally deductible and coinsurance|
|Schedule of benefits document||SUBlue [PDF]||SUOrange [PDF]||SUPro [PDF]|
The University’s retiree health plan contributions vary based on your retirement date, eligibility for Medicare, and whether you are eligible for University-subsidized coverage. Consult the Retirees and COBRA Participants: 2021 Benefits Guide for more information.
Should I expect to receive an Explanation of Benefits (EOB) each time I receive a service from a provider?
Each month, you will receive a Monthly Health Statement, which shows the claims that Excellus BCBS has processed for you and your family for the previous month. Your Explanation of Benefits (EOBs) are available online, unless you specifically request a paper copy from your dedicated customer service representative. As an exception, if you receive care from a non-participating provider, you will automatically receive an EOB at your home address on record with Excellus BCBS.
The Opt Out/Opt In provision is available to those who retired after Jan. 1, 2006 and 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, visit our online resources. If you have any questions about opting out of a University plan, you may contact HR Shared Services at 315.443.4042 or email@example.com.
Yes. Excellus has a local, DeWitt-based, dedicated customer service center for Syracuse University. The phone number and expanded hours of operation are:
800.493.0318 (TTY: 800.662.1220)
Monday through Thursday: 8 a.m.–8 p.m.
Friday: 9 a.m.–8 p.m.
These experienced representatives are well-versed in the Syracuse University plan designs and stand ready to assist you with any health plan questions that you may have.
Yes, you can access the Excellus BCBS online provider directory to view doctors, hospitals and other facilities that participate with the network. Follow these steps to assist with your search:
On the top blue menu bar, click on “Find a Doctor”, then:
- Choose “Find a Doctor, Provider or Facility”
Select your provider’s location:
- Choose I’m a Member or I’m a Guest to start search.
- If using ‘Guest search’ make sure you adjust your Current Location on the top navigation bar to the area in which you are searching for a provider.
- Complete the identified steps to narrow your search.
- Review and accept the terms and conditions for using the website.
- You will be asked to enter the first three letters of your Member I.D. card. Enter VYK.
- Complete the remaining steps to narrow your search.
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. For 2021, the SUBlue and SUOrange plans have an annual in-network deductible of $150 per person with a maximum of $300 for a family. The SUPro plan has an annual in-network deductible of $200 per person with a maximum of $400 for a family. Once the annual deductibles have 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. An overview of deductibles, copays and coinsurance can be found in the Schedule of Benefits documents.
Reference our Coverage Examples Guide [PDF] to see, in general, how the deductible and copay/coinsurance are applied to certain services for SUBlue, SUOrange and SUPro.
You will maximize the value of your benefit when your physician or facility participates in the Excellus BCBS network. If your provider does not participate and you would like Excellus BCBS to attempt to recruit him or her, please contact Excellus at 800.493.0318 (TTY: 800.662.1220). Excellus BCBS will reach out to providers who do not participate with their network and are recommended by Syracuse University’s health plan members.
If I am eligible for prescription drug coverage, how do I find out if the drug my doctor prescribed is covered by our plan?
A formulary is a list of the drugs OptumRx has selected as the preferred medication(s) in each drug class based on their safety, efficacy and cost. A drug can be placed on one of three tiers. A drug that is excluded is not eligible for any plan coverage. Talk with your prescriber about covered alternatives for excluded drugs to avoid paying full retail price.
A formulary can be updated at any time, especially as new drugs are introduced to the market and generic equivalents become available for brand-name drugs. This can affect your share of the cost. You can search OptumRx’s online formulary when you log in to the secure member website. You can also call to speak with an OptumRx member services representative, 24 hours a day, seven days a week at 866.854.2945 (TTY: 711).
If you are impacted by any prescription drug formulary change or program that targets safety and proper usage of certain drugs, you will be notified by OptumRx prior to Jan. 1 with additional details.
If I am eligible for prescription drug coverage, why should I consider talking with my doctor about the possibility of taking a generic drug?
Generic medications are FDA-approved drugs that contain the identical active ingredient in the same strength as the brand-name drug. Generic drugs must meet the same standards for safety, purity, potency and quality as the branded drug, but are priced lower than the brand-name product. To encourage the use of generics, if a generic is available and you or your doctor choose to get the brand name drug (by checking the “Dispense as Written” box on the prescription), you will pay the generic copay plus the difference between the brand name drug cost and the generic drug cost.
If I am eligible for prescription drug coverage, why may I want to consider using OptumRx Home Delivery, rather than my local pharmacy?
If you take certain medications on a daily basis, you may wish to fill those prescriptions using home delivery, which offers convenient mail order service with free standard shipping. Enroll in home delivery on the OptumRx secure member website. Orders are generally received within 14 days.
When you use home delivery, the mail-order cost sharing applies, which may be a lower cost to you than filling a prescription at a retail pharmacy. Savings vary for each medication and are not guaranteed.
Use the OptumRx Home Delivery Order Form [PDF] to mail in prescriptions and payment to OptumRx. Your health care provider can also e-prescribe or fax prescriptions on your behalf.
NOTE: You can fill up to a 90-day supply of medication either at a retail pharmacy or through OptumRx Home Delivery. When you use home delivery, the mail-order cost sharing applies, which may result in considerable savings over your cost at a retail pharmacy. Savings vary for each medication and savings are not guaranteed. Use the Price and Save tool on the OptumRx website or call OptumRx Member Services at 866.854.2945 (TTY: 711) to determine which method is best for each drug you take.
If I am eligible for prescription drug coverage, what do I need to be aware of if my doctor prescribes a specialty drug to me?
Specialty medications are those that treat serious chronic conditions, such as Crohn’s disease, rheumatoid arthritis and multiple sclerosis. Specialty medications often require special handling or refrigeration, and may be self-injected rather than taken orally. You will need to obtain your specialty drugs through the Optum Specialty Pharmacy. The Optum Specialty Pharmacy is a mail-order pharmacy that focuses on providing you with the best possible care while you receive treatment with a specialty medication. Please contact Optum at 844.265.1761 (TTY: 711) to set up your account and coordinate delivery of your medication.
If I am eligible under COBRA for dental and vision, are there any plan changes I need to be aware of?
A new two-year commitment cycle for the University’s dental and vision plans will start Jan. 1, 2021. Dental and vision benefits will continue to be administered by Delta Dental and VSP Vision. There are no benefit changes or increases to premiums for dental, and if you add vision coverage to your dental election, your premium will decrease for 2021.
The University continues to offer a preventive dental plan, which covers two cleanings per year and other basic services, as well as a comprehensive dental plan that provides for both basic and major restorative services, including oral surgery, endodontics, periodontics and prosthodontics. The VSP Vision Care Plan provides coverage for routine eye exams, contact lens care, glasses and frames. Check out our online resources to ensure you’re using your dental and vision benefits to the fullest.
Syracuse University offers two subsidized dental options through Delta Dental:
The Preventive Plan [PDF] provides coverage for two annual exams and cleanings per calendar year and temporomandibular joint dysfunction (TMJ) services. To help maintain your oral health during pregnancy, Delta Dental offers one additional exam and cleaning to pregnant women.
The Comprehensive Plan [PDF] provides coverage for services listed in the Preventive Plan, as well as for basic and major restorative services, oral surgery, endodontics, periodontics and prosthodontics. During pregnancy, women may elect either the enhanced benefit for pregnant women in the Preventive Plan or one additional periodontal scaling and root planing per quadrant.
Delta Dental gives you access to two networks of participating providers: the Delta Dental PPO network and the Delta Dental Premier network. Using a dentist in the PPO network provides the best value. A dentist in the Premier network is the next best option if you can’t find a PPO dentist. Participating dentists in both networks will accept the Delta Dental payment without billing you for any uncovered balance, so you will usually save when compared to a non-participating dentist. You can search online for participating dentists on Delta Dental’s website or call Delta Dental at 800.932.0783 (TTY: 711).
If you are enrolled in dental with vision coverage, vision benefits are provided through VSP. Vision is not available as a separate option.
- Coverage is provided for routine eye exams, contact lens care, glasses and frames.
- To view a summary of the services covered and benefits provided, please view the VSP Vision Care Benefits Summary [PDF] for details.
- Enhanced services are available to diabetics under the Diabetic Eyecare Plus [PDF]
- To maximize your plan benefits, use an in-network provider.
Contact VSP Member Services at 800.877.7195 (TTY: 800.428.4833) or visit vsp.com should you have any questions.
All payments must be sent to Lifetime Benefits Solutions’ payment processing center in Omaha, Nebraska. The address is Lifetime Benefit Solutions, P.O. Box 2979, Omaha, NE 68103-2979. You have the following options to make your payment each month:
- Send a payment directly to Lifetime Benefit Solutions’ payment center using a check or money order, along with your remittance coupon.
- Enroll in automatic monthly withdrawals (ACH) by completing the ACH Request Form. To request a form, contact Lifetime Benefit Solutions directly.
- Make a payment via credit card or electronic check by calling Lifetime Benefit Solutions at 800.493.0318 (TTY: 800.662.1220), Monday through Thursday from 8 a.m.–5 p.m. and Friday from 9 a.m.–5 p.m. EST.
Please note the following:
- You must be current with payments before ACH will begin. Therefore, you must make your first payment by check or money order, and the following month, the payment will be made via ACH.
- Retiree medical plan premium withdrawals are completed on or around the fifth business day of the month for that month’s premium.
- If you are enrolled in COBRA, these withdrawals are completed on the last business day of the month for the next month’s premium.
Lifetime Benefit Solutions’ payment processing center is located in Omaha, Nebraska. However, if you have any questions regarding your billing or general plan administration, contact the Lifetime Benefit Solutions customer care center in DeWitt at 800.493.0318 (TTY: 800.662.1220), Monday through Thursday: 8 a.m.-5 p.m. and Friday: 9 a.m.-5 p.m. EST.
Every effort has been made to ensure that the information contained within this website is accurate. However, benefits are governed by legal documents (which, in certain circumstances, may include insurance contracts). If there is any difference between the information on this website and the official documents, the official documents will control. As is the case with all of Syracuse University’s benefit plans, the University reserves the right to modify or terminate these benefits at any time.