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2017RETIREE NEWS FOR RETIREES WHO RETIRED BEFORE JANUARY 1, 2006 2018 BENEFITS NEWS Welcome to the 2017 edition of Retiree News, your source for information about your health plan coverage through Syracuse University for 2018. We are committed to providing an excellent set of health benefits to protect both the physical and financial well-being of you and your family. The medical plan highlights for next year include the following: ? There will be no increase in the monthly retiree contributions for subsidized coverage. ? Effective Jan. 1, 2018, Excellus BlueCross BlueShield (Excellus BCBS) will be the medical plan administrator and Lifetime Benefit Solutions will be the retiree/COBRA billing administrator, replacing POMCO. OptumRx will continue to provide prescription drug coverage to those who are eligible. ? Members enrolled in SUBlue and SUOrange will no longer be required to obtain referrals to see in-network providers. ? Copays for certain medical services will increase by $10. This is the first increase in four years. An annual in-network deductible will be applied to SUBlue and SUOrange. All copays and deductibles are listed on the University’s website, openenrollment.syr.edu/2017-open-enrollment-overview/ retiree-and-cobra-news/. ? Shortly, you will receive information in the mail from Excellus BCBS and Lifetime Benefit Solutions. If you are enrolled in medical as of Jan. 1, 2018, the information you receive from Excellus BCBS will include your new insurance card. The information you receive from Lifetime Benefit Solutions will explain their billing process. The contact information for Excellus and Lifetime Benefit Solutions is listed below. LEARN MORE ABOUT EXCELLUS BCBS Now through Jan. 1, 2018: ? Confirm your providers are in Excellus’ network: openenrollment.syr.edu/excellus-bcbs-provider-directory. ? Take the opportunity to speak with an Excellus BCBS representative one on one during the on-campus office hours. See the schedule posted online openenrollment.syr. edu/wp-content/uploads/2017/10/Excellus-Office-Hours_final.pdf. ? Call our dedicated Excellus BCBS customer service center at 800.493.0318 (TTY /TTD: 800.662.1220) if you need additional assistance regarding your personal medical questions. Excellus BCBS has expanded hours of operation: Monday– Thursday: 8 a.m.–8 p.m. Friday: 9 a.m.–8 p.m. ? Call our dedicated Lifetime Benefit Solutions customer service center at 800.493.0318 option #3 with any retiree billing questions. Lifetime Benefit Solutions is a subsidiary of Excellus BCBS with offices in Liverpool, New York. The hours of operation are Monday-Thursday: 8 a.m.-5 p.m. Friday: 9 a.m.-5 p.m. INTRODUCING EXCELLUS BLUECROSS BLUESHIELD Beginning Jan. 1, 2018, Excellus BCBS will replace POMCO as the administrator for all Syracuse University medical plans. As an Upstate New York-based provider with offices in DeWitt, Excellus BlueCross BlueShield was selected because of its many strengths and capabilities, including its comprehensive health management programs to ensure exceptional patient care and commitment to providing the highest level of customer service to our members. Excellus BCBS will hold on-campus office hours twice per week this fall and into 2018. An experienced representative from Excellus will be available to assist members with any personal health questions. We encourage everyone to take the opportunity to speak with an Excellus BCBS representative one on one during the on-campus office hours. A schedule is posted online at openenrollment.syr.edu/wp-content/ uploads/2017/10/Excellus-Office-Hours_final.pdf. Registration is not required. MEDICAL PLAN CHANGES As in the past, we offer those who retired before Jan. 1, 2006, and their eligible dependents two medical plan options: SUBlue and SUOrange. All plan options include medical benefits administered by Excellus BCBS, and prescription drug benefits (for those who are eligible) administered by OptumRx. SUBlue and SUOrange will be modified in the following three ways as of Jan. 1, 2018: 1. Referrals will no longer be required to see a provider to receive in-network benefits. Services will either be covered as in-network or out-of-network under SUBlue. It’s important to note that SUBlue offers out-of-network coverage, while SUOrange generally covers only in-network services. SUOrange does not provide out-of-network coverage except in limited emergency situations. Our partnership with Excellus BCBS provides members with access to in-network doctors and hospitals in 200 countries worldwide—providing you and your loved ones with financial security when traveling abroad. 2. While the University has successfully held copays steady for the last four years, in order to continue to manage our costs and offer comprehensive health management programs, services that currently require a member copay of $20, $25, or $40 will increase by $10. These include services such as office visits, diagnostic machine tests, physical therapy, and chiropractic care. All other services will remain at the copays in place for 2017. 3. There will now be an annual deductible of $100 per individual with a maximum of $250 for a family for in-network services. 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. Once the annual deductible has 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. All copays and deductibles are listed in the Schedule of Benefits available online at openenrollment.syr.edu/2017open-enrollment-overview/retiree-and-cobra-news/, along with a frequently asked questions resource guide that applies specifically to retiree and COBRA participants. PROVIDER DIRECTORY With the change to Excellus BCBS in 2018, the network of participating providers will change. While Excellus BCBS offers access to the largest nationwide provider network, you should confirm your providers participate with the network. Visit our website, openenrollment.syr.edu/ excellus-bcbs-provider-directory/, to search Excellus’ provider directory. NEW I.D. CARDS If you are enrolled in medical as of Jan. 1, 2018, you will receive a new Excellus BCBS I.D. card in mid-December at your home address. Please be sure to use this new card, beginning Jan. 1, 2018, the next time you visit your provider. If you don’t receive your I.D. card in the mail, contact our dedicated Excellus BCBS customer service center at 800.493.0318 (TTY /TTD: 800.662.1220). ENHANCED VACCINATION OPTIONS Annual vaccination is an important step you can take to protect yourself and others from the flu. Get your flu shot and other covered vaccines at more than 68,000 participating pharmacies with $0 copay when you utilize your OptumRx member I.D. card. For vaccines not provided through a pharmacy, you may continue to obtain covered vaccines through your doctor’s office using your medical plan I.D. card. Prescription drug coverage may not be applicable for all retirees. If you are not eligible for prescription drug coverage through the University, please disregard all references to OptumRx. STAY HEALTHY and GET VACCINATED SEPT.–DEC. 31, 2017 Use your OptumRx member I.D. card at a participating pharmacy to receive covered vaccines for $0 copay. For Vaccines Not Covered through a Pharmacy You and your eligible dependents may continue to obtain covered vaccines through your doctor’s office using your POMCO I.D. card. BEGINNING JAN. 1, 2018 For maximum flexibility, you may use either your OptumRx or your Excellus BCBS member I.D. card when receiving covered vaccines at a participating pharmacy for $0 copay. For Vaccines Not Covered through a Pharmacy You and your eligible dependents may continue to obtain covered vaccines through your doctor’s office using your Excellus BCBS I.D. card.Vaccines Currently Provided through Pharmacies in New York State* Flu, pneumonia, Tdap (Tetanus, Diphtheria, and Pertussis), meningococcal and shingles vaccines are eligible for individuals over the age of 18. *Contact your local pharmacy to determine your state’s coverage options. If you have questions about covered vaccines not provided through a pharmacy, please contact our medical plan administrator. NURSE LINE AVAILABLE 24/7 With Excellus BCBS, medical plan participants can contact a nurse by phone anytime—24 hours a day, seven days a week. Excellus BCBS nationwide specially trained registered nurses can provide support and education for members with chronic or complex health conditions, or provide answers to more general health questions. Key features of the nurse line include: ? Decision-making support and education when you need it most ? Triage to appropriate level of care ? Information regarding diagnoses, medications, and treatment options ? Assistance with finding providers ? Nutritional information HEALTH QUESTIONS? ASK A NURSE TODAY! Call Excellus BCBS Nurse line 800.493.0318 (TDD/TTY: 800.662.1220) RETIREE MEDICAL PLAN RATES (SUBSIDIZED COVERAGE) Retirees and dependents who retired before January 1, 2006, have subsidized coverage through the end of the five-year period that begins on the date the retiree or dependent becomes eligible for Medicare OR the date the retiree retires from Syracuse University, whichever is later. At age 65, you must be enrolled in Medicare Parts A and B in order to have coverage under the University’s Retiree Medical Plan. Remember, if you or any of your covered dependents are not yet 65 but are Medicare-eligible, you and/or they must enroll in Medicare Parts A and B immediately and notify our medical plan administrator. Medicare integration applies to individuals eligible for Medicare whether or not they are enrolled in Medicare; if a Medicare-eligible individual decides not to enroll in Medicare, out-of-pocket costs for claims made under the plan are likely to be significantly higher. If you have questions about this, contact POMCO at 877.461.7844. Starting Jan. 1, 2018, contact Excellus BCBS at 800.493.0318(TTY /TTD: 800.662.1220). Contributions are required for pre-65 coverage only. Below is the schedule of monthly rates for subsidized coverage. THERE ARE NO MEDICAL PLAN RATE CHANGES FOR PRE-65 SUBSIDIZED COVERAGE IN 2018 2018 MONTHLY MEDICAL RATES FOR PRE-65 COVERAGE* SUBLUE Schedule A Retiree Only: $142.15 $138.02 $120.90 Retiree + Spouse/Domestic Partner: $312.73 $303.63 $265.98 Retiree + Child(ren): $274.35 $266.37 $233.34 Retiree + Spouse/Domestic Partner + Child(ren): $444.93 $431.98 $378.42Schedule BRetiree Only: $124.53Retiree + Spouse/Domestic Partner: $273.95Retiree + Child(ren): $240.33Retiree + Spouse/Domestic Partner + Child(ren): $389.76SUORANGESchedule A Retiree Only: $138.02 Retiree + Spouse/Domestic Partner: $303.63 Retiree + Child(ren): $266.37 Retiree + Spouse/Domestic Partner + Child(ren): $431.98 Schedule BRetiree Only: $120.90Retiree + Spouse/Domestic Partner: $265.98Retiree + Child(ren): $233.34Retiree + Spouse/Domestic Partner + Child(ren): $378.42 *A monthly administrative fee will apply. QUALIFYING FOR SCHEDULE B REDUCED MEDICAL RATES Depending on your household income and size, you may be eligible for lower medical rates. If you think you may qualify, complete the application by Dec. 8. You will be notified after this date if your application is approved. You must apply each year to receive a reduced rate. For more information and a copy of the application, visit the Schedule B website hr.syr.edu/scheduleb. ELIGIBILITY FOR SCHEDULE B RATES HOUSEHOLD SIZE: 1 HOUSEHOLD INCOME: Less than $36,000 HOUSEHOLD SIZE: 2 HOUSEHOLD INCOME: Less than $49,000 HOUSEHOLD SIZE: 3 HOUSEHOLD INCOME: Less than $61,000 HOUSEHOLD SIZE: 4 and up HOUSEHOLD INCOME: Less than $74,000 RETIREE MEDICAL RATES (NON-SUBSIDIZED COVERAGE) At the end of your five-year period (which began on the date on which you either became eligible for Medicare or you retired from SU, whichever is later), subsidized coverage will end. You may elect to continue SU retiree medical coverage on a non-subsidized basis, provided that you enroll in Medicare Parts A and B if eligible. Information will be mailed to you from our retiree billing administrator approximately two months before your coverage ends. Please keep in mind that because this option does not include prescription drug coverage, you should consider enrolling in a separate Medicare Part D prescription drug plan once you are eligible for Medicare. We recommend that you make plans three months in advance to replace your SU prescription coverage. The non-subsidized medical plan costs for 2018 are indicated in the table below. MONTHLY COST PER PERSON* SUBlue $151.81 SUOrange $146.57 *A monthly administrative fee will apply. THE HEALTH PLANS AND THE MARKETPLACE The University retiree health plans, including SUBlue and SUOrange, meet the coverage requirements of the Affordable Care Act. This means that if you or your dependents are enrolled in either of these plans, or public programs such as Medicare or Medicaid, you meet the individual mandate requiring everyone to have health insurance. However, given the variety of health insurance options available through the Marketplace of private insurers and the subsidies available, you may want to consider whether private insurance is a good option for you and your dependents. More information on the Marketplace is available by phone at 800.318.2596 (Federal) and 855.355.5777 (New York State), and online at (Federal) or nystateofhealth. (New York State). You should also compare the coverage and cost of these plans with those available to you through a spouse or domestic partner. COMPARISON MADE EASY Choosing health coverage is an important decision. To help you make an informed choice, a Summary of Benefits and Coverage (SBC) is available to you. An SBC summarizes important information about health coverage in a standard format to help you compare features across coverage options available to you. Please keep in mind that the University’s SBCs are not specific to our retiree medical plans and therefore some benefits, such as prescription drug coverage, may not be applicable. The SBCs for the SUBlue and SUOrange coverage options are posted on this website: hr.syr.edu/sbc. Paper copies of the SBCs also are available, and may be requested at any time free of charge by contacting the HR Service Center at 315.443.4042 or hrservice@syr.edu. TIME TO REVIEW DEPENDENT ELIGIBILITY Please review and remove any dependents you have on your plans who no longer meet the definition of eligible dependent. To review the eligible dependent criteria, see the Benefits Eligibility Policy openenrollment.syr.edu/benefitseligibility. 2017 RETIREE NEWS LEGAL NOTIFICATIONS Notice Regarding the Syracuse University Group Health Plans Notice of Privacy Practices The Syracuse University Group Health Plans Notice of Privacy Practices (NPP) summarizes the privacy practices of these group health plans. You have the right to receive a copy of the NPP (either electronically or a paper copy) at any time. Even if you have previously agreed to receive the NPP electronically, you are entitled to a paper copy of the NPP. You may review or print out a copy of the NPP online at supolicies.syr.edu/ emp_ben/hipaa.htm. You may also contact the HR Service Center at 315.443.4042 for a paper copy. Notice Regarding the Women’s Health and Cancer Rights Act of 1998 The medical plan, as required by the Women’s Health and Cancer Rights Act of 1998, provides benefits for mastectomy-related services, including all stages of reconstruction and surgery to achieve symmetry between the breasts, prostheses, and complications resulting from a mastectomy, including lymphedema. Call POMCO at 877.461.7844 for more information. Starting Jan. 1, 2018, contact Excellus BCBS at 800.493.0318 (TTY/TTD: 800.662.1220). Discrimination is Against the Law Syracuse University Retiree Prescription Drug Plan complies with applicable federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability, or sex. Syracuse University Retiree Prescription Drug Plan does not exclude people or treat them differently because of race, color, national origin, age, disability, or sex. Syracuse University Retiree Prescription Drug Plan: Provides free aids and services to people with disabilities to communicate effectively with us, such as: ? Qualified sign language interpreters ? Written information in other formats (large print, audio, accessible electronic formats, other formats) Provides free language services to people whose primary language is not English, such as: ? Qualified interpreters ? Information written in other languages If you need these services, contact Sheila Johnson-Willis, interim chief, Equal Opportunity & Title IX Officer. If you believe that Syracuse University Retiree Prescription Drug Plan has failed to provide these services or discriminated in another way on the basis of race, color, national origin, age, disability, or sex, you can file a grievance with: Sheila Johnson-Willis, interim chief, Equal Opportunity & Title IX Officer, 005 Steele Hall, Syracuse University, Syracuse, NY 13244, telephone 315.443.0211, fax 315.443.5021 or sjohnson@syr.edu. You can file a grievance in person or by mail, fax, or email. If you need help filing a grievance, Sheila Johnson-Willis is available to help you. You can also file a civil rights complaint with the U.S. Department of Health and Human Services, Office for Civil Rights, electronically through the Office for Civil Rights Complaint Portal, available at , or by mail or phone at: U.S. Department of Health and Human Services 200 Independence Avenue, SW Room 509F, HHH Building Washington, D.C. 20201 800.368.1019, 800.537.7697 (TDD) Complaint forms are available at index.html. ATENCI?N: si habla espa?ol, tiene a su disposición servicios gratuitos de asistencia lingüística. Llame al 315.443.0211. ATTENTION : Si vous parlez fran?ais, des services d’aide linguistique vous sont proposés gratuitement. Appelez le 315.443.0211. Every effort has been made to ensure the information in this newsletter is accurate. However, the benefits are governed by legal documents (which, in certain circumstances, may include insurance contracts). If there is any difference between the information in this newsletter and the official documents, the official documents will control. The University reserves the right to modify or terminate these benefits at any time. CONTACT US Questions about your benefits? You can get the answers by contacting the HR Service Center at 315.443.4042 or hrservice@syr.edu. Questions regarding enrollment and billing should be directed to Lifetime Benefit Solutions at 800.493.0318 option # 3. ................
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