SYRACUSE UNIVERSITY Onboarding Information

Transcription

1 2015 Onboarding Information

2 CONTACT INFORMATION POMCO Delta Dental WageWorks Express Scripts MetLife Auto/Home: , x1 Life Conversion: SEBF Dental/Vision The Standard TIAA-CREF CUSE (2873) Vision Service Plan (VSP) Nurse Line Syracuse University Human Resources Benefits Service Center Dependent and Remitted Tuition Employment/Staff Relations Faculty and Staff Assistance Program Harassment and Discrimination Student Employment Services WorkLife and Organizational Development

3 WELCOME TO SYRACUSE UNIVERSITY It is our pleasure to welcome you to Syracuse University. This packet has been prepared to guide you through the benefits we offer our employees and to provide a reference for your questions. Beyond the basics found in this packet, the Human Resources website, offers specific information on policies and procedures and is continually updated with the most current benefit information. In addition to the Onboarding session you are attending, you will be invited to attend either the faculty or staff orientation where you will learn more about the campus and explore your role as part of the University community. We hope you find this packet a valuable resource as you begin your Syracuse University career. Sincerely, Human Resources Service Center Page 1 January 2015

4 First Week: First Month: NEW EMPLOYEE TO-DO S Complete a TIAA-CREF waiver form, if applicable. Complete Employment Eligibility Verification (I-9) at Human Resources. Obtain an SU Identification Card from the Office of Housing, Meal Plan, and I.D. Card Services at 206 Steele Hall. Schedule your Hazard Communication Training online at Attend a post-employment health check, if applicable. Activate your NetID at: so that you have access to online resources and services such as: , electronic documents, and MySlice, the University web portal that allows you access to SU s annual benefits Open Enrollment and other employee services. To register for FAB General Overview training, if applicable, please go to For additional training regarding the General Ledger Financial Reports, please contact General Accounting at or [email protected]. Review benefits information and enroll as soon as possible. IMPORTANT: You must enroll within the first 31 days of employment. Attend New Employee Orientation, if applicable: Location: Goldstein Student Center Room 201AB&C Page 2 January 2015

5 TABLE OF CONTENTS New Employee To-Do s... 2 Retirement Planning... 5 Group Health Insurance... 6 SUBlue and SUOrange Schedule of Benefits and Employee Cost Sharing... 9 SUPro Schedule of Benefits and Employee Cost Sharing Group Dental & Vision Insurance Flexible Spending Accounts (FSA) The University Wellness Initiative Group Life Insurance Accidental Death and Dismemberment (AD&D) Insurance Will Preparation Service Dependent Life Insurance Disability Benefits Plan for EXEMPT Employees (Salary Continuation) Disability Benefits Plan for NON-EXEMPT Employees Workers Compensation Voluntary Long Term Disability Insurance Remitted Tuition Benefits Dependent Tuition Benefits Paid Time Off for Staff Employees Leave of Absence MetLife Home and Auto Insurance Home Mortgage Program Identification Cards Faculty and Staff Assistance Program (FSAP) Adoption Assistance Lesbian, Gay, Bisexual and Transgender (LGBT) Resource Center Worldwide Travel Protection Notice of Special Enrollment Rights Continuation of Health Coverage/COBRA Notice of Privacy Practices Notice Regarding the Women s Health and Cancer Rights Act of Summary of Benefits and Coverage Information Security WorkLife at SU Benefit Providers Contact Information University Contact Information Page 3 January 2015

6 2015 BENEFITS PLAN OVERVIEW The following pages summarize your Syracuse University benefit options. Every effort has been made to ensure this information 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 the Onboarding book and the official documents, the official documents will control. Eligible employees electing to participate in SU benefit plans, programs or policies are bound by the terms of the governing plan, program and policy documents. If you have any questions regarding the plans, programs or policies, you may request a copy of the governing document by contacting the HR Service Center at or [email protected]. As is the case with all benefits offered by SU, (1) the SU administrator of the applicable benefit plan, program or policy has the discretionary authority to interpret the terms of that plan, program or policy, and such interpretation will be binding on all interested parties to the est extent permitted by law, and (2) the University reserves the right to modify or terminate its benefit plans, programs and/or policies at any time. Syracuse University is proud of the comprehensive benefits package provided to eligible faculty and staff. This section discusses these benefits in detail and further information is provided on the HR website. Page 4 January 2015

7 RETIREMENT PLANNING Noncontributory Retirement Plan Upon completion of your first year of employment, Syracuse University will contribute the equivalent of 10% of your base salary (with a maximum annual contribution of $26,500) toward your retirement annuity and will continue this contribution annually, if eligible. Once eligible, the University contribution will default into a T. Rowe Price Target Date Fund that is administered through the Teachers Insurance and Annuity Association and College Retirement Equities Fund (TIAA-CREF). The Target Date Funds are a group of funds managed by T. Rowe Price based on your age and expected retirement date. If you have an existing account with TIAA-CREF, they may contact you directly for further information. Once enrolled, you can make changes to these funds by contacting TIAA-CREF by phone at or online at: You may also schedule a one-on-one appointment with a TIAA-CREF advisor by calling for meetings on campus, or at the local TIAA-CREF office at 250 South Clinton Street, Suite 310 in Syracuse. Waiving the one-year waiting period The one-year waiting period is waived for faculty and staff joining the University from another accredited four-year institution that confers a baccalaureate degree. In order to waive the University s one-year waiting period you must meet the criteria provided on the waiver form. Please find the waiver form to be completed by you and your previous employer at: Once the waiver form has been completed by your previous employer, you should review it for accuracy, sign and date it, and return it to the Human Resources Service Center. This can be accomplished by fax ( ) or ([email protected]). This waiver will go into effect when the completed form is returned, reviewed and processed by the HR Service Center. Please keep in mind that there is no retroactive contribution of the University s 10% contribution. Voluntary Retirement Plan Upon employment, you are eligible to participate in the University s Voluntary Retirement Plan through TIAA-CREF up to the maximum amount established by law. To enroll, complete the Voluntary Salary Reduction Form online at: Voluntary contributions may be made to either a pre-tax Traditional 403(b) or a post-tax Roth 403(b). More information on these plans is available online at: Page 5 January 2015

8 Group Health Insurance Health Care Upon employment, Syracuse University offers three health insurance options: SUBlue, SUOrange, and SUPro. All three health plans are administered through POMCO and prescription drug benefits are administered by Express Scripts, formerly Medco. The premiums you pay for medical coverage include the prescription drug benefit coverage. Medical Benefits SUBlue is a point of service plan (POS) that allows members to receive services from any provider subject to certain plan restrictions. There are three levels of coverage in the SUBlue plan as follows: o o o Level One - Services must be performed by a provider that participates with the POMCO-PHCS/MultiPlan network, regardless of their location, and coordinated by your Primary Care Physician (PCP). Level Two - Services are performed by any provider participating in the POMCO-PHCS/MultiPlan network but are not coordinated by your PCP. Level Three - Services are performed by a provider that does not participate in the POMCO-PHCS/MultiPlan network. SUOrange coverage is nearly identical to SUBlue coverage except that services are restricted to those providers that participate directly with POMCO-PHCS/Multiplan network (Level One coverage only). SUPro In general, the same services covered under SUBlue and SUOrange are also covered under SUPro but with a different copayment/ structure. There are no referrals needed to see a specialist under SUPro. However certain services require prior authorization. There are two levels of coverage in the SUPro plan as follows: o o Level One - Services must be performed by a provider that participates with the POMCO-PHCS/MultiPlan network, regardless of their location. Coordination with your Primary Care Physician (PCP) is not required. Level Two - Services are performed by a provider that does not participate in the POMCO-PHCS/MultiPlan network. Coverage for International Travel: When traveling outside the United States, whether on University business or not, coverage will be deemed Level One (in-network) for SUBlue and SUPro. For information on how to submit a claim for services received internationally, contact POMCO at GO1-SU44. Page 6 January 2015

9 Prescription Drug Benefits Generics To encourage the appropriate use of generics, if a generic equivalent is available and you choose to have the brand name drug, or your doctor prescribes the script Dispense 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. Biotech/Specialty drugs Prescription drugs in the Biotech/Specialty class, required to be filled through mail order, will be limited to a 30-day supply per refill. The payment schedule is the same as the mail order schedule according to the medical plan to which you subscribe. Retail 90-Day Network Subscribers may fill a 90-day supply at a local participating pharmacy in addition to the mail order option. The payment schedule is the same as the retail pharmacy schedule according to the medical plan to which you subscribe. See the HR website ( for pharmacies participating in this program. Express Scripts By Mail If you take certain prescription medications on an ongoing basis, you can fill your prescriptions using Express Scripts By Mail, which offers convenient mail order service with free standard shipping. Once you start, you can refill and renew your prescriptions at the Express Scripts website. Your mail order prescriptions can be sent to Express Scripts by fax, by mail or online. o Fax: Ask your doctor to obtain fax forms and instructions directly by calling EASYRX1 ( ). IMPORTANT: This number is for physicians only. Only your physician may fax the completed form to Express Scripts. Please note: a special fax form is required in the state of Virginia. If you or your doctor are located in Virginia, ask your doctor to obtain the correct form by calling the number listed above. o Mail: Mail in a prescription your physician has written using the mail order form available online at In most cases, your physician can prescribe a 90-day supply, with up to three refills. o Online: Visit the Express Scripts website at and register as a new user to fill your prescription online. Page 7 January 2015

10 2015 Monthly Employee Health Plan Contributions SUBlue SUOrange SUPro Schedule A Schedule B Schedule A Schedule B Schedule A Schedule B Employee $ $ $ $ $ $ Employee + Spouse/ Domestic Partner $ $ $ $ $ $ Employee + Child(ren) $ $ $ $ $ $ Employee + Spouse/ Domestic Partner + Child(ren) $ $ $ $ $ $ Contributions listed here are based on the 12-month calendar year. The actual deduction from your paycheck depends on your deduction cycle. Contributions for domestic partners and their children are paid on an after-tax basis. Benefits Eligibility Please refer to the University s Benefits Eligibility Policy online at to determine if your dependents are eligible for coverage. Schedule B Contributions Eligible employees default into the Schedule A contribution rates for medical coverage unless they qualify, apply and are approved for Schedule B contributions. Applications must be received within 31 days of your date of hire. Eligibility for this program is based on household income and household size according to the chart below: Household Size Household Income 1 Less than $35,000 2 Less than $47,000 3 Less than $59,000 4 and up Less than $72,000 Household size is the number of individuals declared on the most recent Federal Income Tax Returns for you and, if applicable, your spouse or domestic partner. Also included in household size are your children who are not declared on your tax return but are either under age 19 and living with you or age 19 or older and enrolled on your medical plan. Household income is the combined adjusted gross income disclosed on the Federal Income Tax Returns for you, and if applicable, for your spouse or domestic partner and your children age 19 or older, if they are enrolled on your medical plan. Additional information about Schedule B contributions, including the application form, is available online at: Page 8 January 2015

11 SUBLUE AND SUORANGE: SCHEDULE OF BENEFITS 2015 EMPLOYEE COST SHARING SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Cost Sharing Definitions Annual Deductible 1 No deductible No deductible $300 per individual with a maximum of $1,000 family No deductible Coinsurance No 10% allowable amount 30% allowable amount plus the difference between provider s charge and the allowable amount (exceptions noted below) No Annual Out-of- Pocket Maximum 2 $2,000 per individual with a maximum of $4,000 for a family $4,000 per individual with a maximum of $8,000 for a family $6,000 per individual with a maximum of $12,000 for a family $2,000 per individual with a maximum of $4,000 for a family Your Institutional Covered Services INPATIENT HOSPITAL Inpatient hospital $350 copay per admission $350 copay per admission plus Deductible, $350 copay per admission, and $350 copay per admission Nursery care No copay; paid in Coinsurance Deductible and OUTPATIENT HOSPITAL Surgery $200 copay $200 copay plus Deductible, $200 copay, and $200 copay Pre-surgical testing No copay; paid in Coinsurance Deductible and Page 9 January 2015

12 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Routine mammography screenings (one per calendar year for ages 35 and older with exceptions if high risk) No copay; paid in Deductible and Routine prostate cancer screenings (one per calendar year for ages 50 and older with exceptions if high risk) No copay; paid in Deductible and Routine cervical cancer screenings (one per calendar year for ages 18 and older) No copay; paid in Deductible and Colonoscopies No copay; paid in Deductible and Diagnostic machine tests, x-rays, and radiology services (including MRIs, PET and CT scans) $40 copay $40 copay plus Deductible, $40 copay, and $40 copay Diagnostic laboratory tests No copay; paid in Coinsurance Deductible and Occupational therapy (for situations not covered through a governmental program) $25 copay $25 copay plus Deductible, $25 copay, and $25 copay Page 10 January 2015

13 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Physical therapy $25 copay $25 copay plus Deductible, $25 copay, and $25 copay Speech therapy (for situations not covered through a governmental program) $25 copay $25 copay plus Deductible, $25 copay, and $25 copay Respiratory, radiation, cardiac therapies and chemotherapy No copay; paid in Coinsurance Deductible and HOSPITAL EMERGENCY ROOM Hospital emergency room $150 copay $150 copay $150 copay $150 copay (includes out of network coverage) ADDITIONAL INSTITUTIONAL PROVIDERS Ambulatory surgery center $150 copay $150 copay plus Deductible, $150 copay, and $150 copay Birth center No copay; paid in Coinsurance Deductible and Skilled nursing facility (180 inpatient days) $350 copay per admission $350 copay per admission plus Deductible, $350 copay per admission, and $350 copay per admission Home health agency No copay; paid in Coinsurance Deductible and Hospice No copay; paid in Coinsurance Deductible and Page 11 January 2015

14 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Inpatient mental health disorder care (facility charge) General hospital or psychiatric facility Partial hospitalization $350 copay per admission A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. $350 copay per admission plus A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. Deductible, $350 copay per admission, and A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. $350 copay per admission A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. Inpatient substance use disorder detoxification and rehabilitation General hospital or certified alcohol/ substance abuse facility program Partial hospitalization $350 copay per admission; A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. $350 copay per admission plus ; A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. Deductible, $350 copay per admission, and ; A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. $350 copay per admission; A separate copay will apply to partial hospitalization if the patient is discharged to a new facility after inpatient hospitalization. Outpatient treatment for substance use disorders $40 copay $40 copay plus Deductible, $40 copay, and $40 copay Your Professional Provider Covered Services Surgery and assistance at surgery No copay; paid in Coinsurance Deductible and Breast reconstruction surgery No copay; paid in Coinsurance Deductible and Page 12 January 2015

15 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Second opinion No copay; paid in Deductible plus the difference between provider s charge and allowable amount Anesthesia No copay; paid in Coinsurance Deductible and Maternity No copay; paid in Coinsurance Deductible and PROFESSIONAL PROVIDER INPATIENT VISITS Inpatient hospital visits by physician or other professional provider No copay; paid in Coinsurance Deductible and Inpatient substance use disorder hospital visits by physician or other professional provider No copay; paid in Coinsurance Deductible and Inpatient skilled nursing facility visits by physician or other professional provider No copay; paid in Coinsurance Deductible and Inpatient mental health disorder care visits by physician or other professional provider No copay; paid in Coinsurance Deductible and Page 13 January 2015

16 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral PROFESSIONAL PROVIDER VISITS Office visits $25 copay (PCP) or $40 copay (Specialist) $40 copay plus Deductible, $40 copay, and $25 copay (PCP) or $40 copay (Specialist) Well child visits Birth to 2 nd birthday - 9 visits No copay; paid in Deductible plus the difference between provider s charge and allowable amount 2 nd birthday to 7 th birthday - 5 visits 7 th birthday to 19 th birthday - 1 visit per calendar year Routine physical (one per calendar year) No copay; paid in Deductible plus the difference between provider s charge and allowable amount Routine cervical cancer screening (annual routine pap smear) No copay; paid in Deductible and Allergy testing and treatment $25 copay (PCP) or $40 copay (Specialist) $40 copay plus Deductible, $40 copay, and $25 copay (PCP) or $40 copay (Specialist) Consultation service, office $40 copay (Specialist) $40 copay plus Deductible, $40 copay, and $40 copay (Specialist) Consultation service, hospital No copay; paid in Coinsurance Deductible and Page 14 January 2015

17 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Urgent care $50 copay $50 copay plus Deductible, $50 copay, and $50 copay Kidney Dialysis (member with ESRD must sign up for Medicare upon becoming eligible) No copay; paid in Coinsurance Deductible and Outpatient treatment for mental health disorders (1 therapy visit per day) $40 copay (Specialist) $40 copay plus Deductible, $40 copay, and $40 copay (Specialist) Private duty nursing No copay; paid in Coinsurance Deductible and Diabetes education $25 copay (PCP) or $40 copay (Specialist) $40 copay plus Deductible, $40 copay, and $25 copay (PCP) or $40 copay (Specialist) Acupuncture $40 copay $40 copay plus Deductible, $40 copay, and $40 copay Chiropractic services $40 copay No Coverage No Coverage $40 copay Routine vision exam (one exam in 24 consecutive months) $40 copay (Specialist) No Coverage No Coverage $40 copay (Specialist) Page 15 January 2015

18 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Routine hearing exam (one exam in 24 consecutive months) $40 copay (Specialist) No Coverage No Coverage $40 copay (Specialist) THERAPY Occupational therapy (for situations not covered through a governmental program) $25 copay $25 copay plus Deductible, $25 copay, and $25 copay Physical therapy $25 copay $25 copay plus Deductible, $25 copay, and $25 copay Speech therapy (for situations not covered through a governmental program) $25 copay $25 copay plus Deductible, $25 copay, and $25 copay Respiratory, radiation, and cardiac therapies and chemotherapy No copay; paid in Coinsurance Deductible and DIAGNOSTIC SERVICES Diagnostic machine tests, x-rays and radiology services (including MRIs, PET and CT scans) $40 copay $40 copay plus Deductible, $40 copay, and $40 copay Diagnostic laboratory No copay; paid in Coinsurance Deductible and Page 16 January 2015

19 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Routine mammography screenings (one per calendar year for ages 35 and older with exceptions if high risk) No copay; paid in Deductible and Routine prostate cancer screenings (one per calendar year for ages 50 and older with exceptions if high risk) No copay; paid in Deductible and Routine cervical cancer screenings (one per calendar year for ages 18 and older) No copay; paid in Deductible and Colonoscopies No copay; paid in Deductible and Additional Health Services Ambulance $100 copay $100 copay $100 copay $100 copay (includes out of network coverage) Diabetic equipment and supplies $20 copay $20 copay plus Deductible, $20 copay, and $20 copay Durable medical equipment 10% allowable amount 20% allowable amount Deductible and 40% allowable amount plus the difference between provider s charge and allowable amount 10% allowable amount Page 17 January 2015

20 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Breastfeeding Equipment Rental or Purchase No copay; paid in Rental Coverage Only: Deductible and 40% of allowable amount plus the difference between the actual charge and the Allowed Charge. Hearing Aids Across All Levels: Maximum benefit of $750 for a single hearing aid and $1,500 for binaural hearing aids; limited to once every three years Contracted Model: 50% of the billed charge or the allowable amount (whichever is less) Non- Contracted Model: 50% of the billed charge or the allowable amount (whichever is less) plus the difference between the actual charge and the allowable amount. Contracted Model: 50% of the billed charge or the allowable amount (whichever is less) Non-Contracted Model: 50% of the billed charge or the allowable amount (whichever is less) plus the difference between the actual charge and the allowable amount. Deductible and 50% of the billed charge or the allowable amount (whichever is less) plus the difference between the actual charge and the allowable amount. Contracted Model: 50% of the billed charge or the allowable amount (whichever is less) Non-Contracted Model: 50% of the billed charge or the allowable amount (whichever is less) plus the difference between the actual charge and the allowable amount. Medical supplies No copay; paid in Coinsurance Deductible and Prosthetic devices No copay; paid in Coinsurance Deductible and Page 18 January 2015

21 SUBlue (Levels One, Two, and Three) SUOrange Level One POMCO/PHCS/ MultiPlan With Referral Level Two POMCO/PHCS/ MultiPlan Without Referral Level Three Out of Network Level One POMCO/PHCS/ MultiPlan With Referral Prescription Drugs Covered through Express Scripts Covered through Express Scripts Covered through Express Scripts Covered through Express Scripts 1 Level Three coverage requires the employee to pay an annual deductible before any other cost sharing is determined. The annual deductible is $300 per individual with a maximum of $1,000 for a family. After the annual deductible is satisfied, the employee must pay the copay, if applicable. The is then applied to the balance of the allowable amount. The employee is also responsible for the difference between the provider s charge and the allowable amount as defined by POMCO. 2 Out-of-pocket maximum refers to the maximum amount of out-of-pocket expenses an employee would pay in a calendar year. The out-of-pocket expenses are defined as the deductibles,, and copayment amounts, exclusive of amounts for prescription medicines. The differences between provider charges and the allowable amounts under level three are not subject to the out-of-pocket maximum. Each medical program is governed by the plan document. If there is any difference between the information on these summary sheets and the plan document, the plan document will rule. Annual Deductible Out-of-Pocket Maximum Retail: Generic Retail: Brand Formulary Retail: Brand Non-Formulary Prescription Drugs No Deductible $2,000 per individual with a maximum of $4,000 for a family 20% * 25% 45% Mail Order: Generic $20* Mail Order: Brand Formulary $50 Mail Order: Brand Non-Formulary $90 Specialty Mail Order (All) Same as Mail Order except 30 day supply Contraceptives Follows above schedule for retail and mail order * Generic Prescription Drugs: $0 copay (Certain Age/Gender Restrictions Apply) Smoking Cessation Drugs Fluoride Women s Contraceptives Vitamin D Supplements Folic Acid Iron Supplements Aspirin Preparatory Prescriptions associated with Colonoscopies Page 19 January 2015

22 SUPro: Schedule of Benefits 2015 EMPLOYEE COST SHARING SU Pro (In-Network and Out-of-Network) In-Network POMCO/PHCS/Multiplan Out-of-Network Cost Sharing Definitions Annual Deductible 1 Coinsurance $200 per individual with a maximum of $400 for a family 5% of allowable amount for inpatient hospitalization - or - 50% of allowable amount for hearing aids - or - 20% of allowable amount for all other services $300 per individual with a maximum of $1,000 for a family 5% of allowable amount for inpatient hospitalization - or - 30% of allowable amount for all other services - plus - Difference between submitted charges and allowable amount Annual Out-of-Pocket Maximum 2 All preventive services covered in $1,500 per individual with a maximum of $3,000 for a family Your Institutional Covered Services $6,000 per individual with a maximum of $12,000 for a family INPATIENT HOSPITAL Inpatient hospital Deductible plus Deductible plus Nursery care Deductible plus Deductible plus OUTPATIENT HOSPITAL Surgery Deductible plus Deductible plus Pre-surgical testing Deductible plus Deductible plus Routine mammography screenings (one per calendar year for ages 35 and older with exceptions if high risk) No ; paid in Deductible plus Page 20 January 2015

23 SU Pro (In-Network and Out-of-Network) Routine prostate cancer screenings (one per calendar year for ages 50 and older with exceptions if high risk) Routine cervical cancer screenings (one per calendar year for ages 18 and older) In-Network POMCO/PHCS/Multiplan No ; paid in No ; paid in Out-of-Network Deductible plus Deductible plus Colonoscopies No ; paid in Deductible plus Diagnostic machine tests, x-rays, and radiology services (including MRIs, PET and CT scans) Deductible plus Deductible plus Diagnostic laboratory tests Deductible plus Deductible plus Occupational therapy (for situations not covered through a governmental program) Deductible plus Deductible plus Physical therapy Deductible plus Deductible plus Speech therapy (for situations not covered through a governmental program) Deductible plus Deductible plus Respiratory, radiation, cardiac therapies and chemotherapy Deductible plus Deductible plus HOSPITAL EMERGENCY ROOM Hospital emergency room Deductible plus In-network deductible plus innetwork ADDITIONAL INSTITUTIONAL PROVIDERS Ambulatory surgery center Deductible plus Deductible plus Page 21 January 2015

24 SU Pro (In-Network and Out-of-Network) In-Network POMCO/PHCS/Multiplan Out-of-Network Birth center Deductible plus Deductible plus Skilled nursing facility (180 inpatient days) Deductible plus Deductible plus Home health agency Deductible plus Deductible plus Hospice Deductible plus Deductible plus Inpatient mental health disorder care (facility charge) - General hospital or psychiatric facility - Partial hospitalization Inpatient substance use disorder detoxification and rehabilitation - General hospital or certified alcohol/substance abuse facility program - Partial hospitalization Outpatient treatment for substance use disorders Deductible plus Deductible plus Deductible plus Deductible plus Deductible plus Deductible plus Your Professional Provider Covered Services Surgery and assistance at surgery Deductible plus Deductible plus Breast reconstruction surgery Deductible plus Deductible plus Second opinion Deductible plus Deductible plus Anesthesia Deductible plus Deductible plus Maternity No ; paid in Deductible plus Page 22 January 2015

25 SU Pro (In-Network and Out-of-Network) In-Network POMCO/PHCS/Multiplan Out-of-Network PROFESSIONAL PROVIDER INPATIENT VISITS Inpatient hospital visits by physician or other professional provider Deductible plus Deductible plus Inpatient substance use disorder hospital visits by physician or other professional provider Inpatient skilled nursing facility visits by physician or other professional provider Deductible plus Deductible plus Deductible plus Deductible plus Inpatient mental health disorder care visits by physician or other professional provider Deductible plus Deductible plus PROFESSIONAL PROVIDER VISITS Office visits Deductible plus Deductible plus Well child visits Birth to 2 nd birthday - 9 visits 2 nd birthday to 7 th birthday - 5 visits 7 th birthday to 19 th birthday - 1 visit per calendar year No ; paid in Deductible plus Routine physical (one per calendar year) Routine cervical cancer screening (annual routine pap smear; one per calendar year) No ; paid in No ; paid in Deductible plus Deductible plus Allergy testing and treatment Deductible plus Deductible plus Consultation service, office Deductible plus Deductible plus Page 23 January 2015

26 SU Pro (In-Network and Out-of-Network) In-Network POMCO/PHCS/Multiplan Out-of-Network Consultation service, hospital Deductible plus Deductible plus Urgent care Deductible plus Deductible plus Kidney dialysis (with ESRD, member must sign up for Medicare upon becoming eligible) Deductible plus Deductible plus Outpatient treatment for mental health disorders Deductible plus Deductible plus Private duty nursing Deductible plus Deductible plus Diabetes education Deductible plus Deductible plus Acupuncture Deductible plus Deductible plus Chiropractic services Deductible plus Deductible plus Routine vision exam (one exam in 24 consecutive months) Routine hearing exam (one exam in 24 consecutive months) Deductible plus Deductible plus Deductible plus Deductible plus THERAPY Occupational therapy (for situations not covered through a governmental program) Deductible plus Deductible plus Physical therapy Deductible plus Deductible plus Speech therapy (for situations not covered through a governmental program) Respiratory, radiation, and cardiac therapies and chemotherapy Deductible plus Deductible plus Deductible plus Deductible plus Page 24 January 2015

27 SU Pro (In-Network and Out-of-Network) In-Network POMCO/PHCS/Multiplan Out-of-Network DIAGNOSTIC SERVICES Diagnostic machine tests, x-rays and radiology services (including MRIs, PET and CT scans) Deductible plus Deductible plus Diagnostic laboratory Deductible plus Deductible plus Routine mammography screenings (one per calendar year for ages 35 and older with exceptions if high risk) Routine prostate cancer screenings (one per calendar year for ages 50 and older with exceptions if high risk) Routine cervical cancer screenings (one per calendar year for ages 18 and older) No ; paid in No ; paid in No ; paid in Deductible plus Deductible plus Deductible plus Colonoscopies No ; paid in Deductible plus Additional Health Services Ambulance Deductible plus In-network deductible plus innetwork Diabetic equipment and supplies Deductible plus Deductible plus Durable medical equipment Deductible plus Deductible plus Breastfeeding Equipment Rental or Purchase Hearing Aids Maximum benefit of $750 for a single hearing aid and $1,500 for binaural hearing aids; limited to once every three years No ; paid in Contracted Model: 50% of the submitted charge or the allowable amount (whichever is less) Non-Contracted Model: 50% of the submitted charge or the allowable amount (whichever is less) plus the difference between the submitted charge and the allowable amount. Rental Coverage Only: Deductible plus Deductible and 50% of the submitted charge or the allowable amount (whichever is less) plus the difference between the submitted charge and the allowable amount. Page 25 January 2015

28 SU Pro (In-Network and Out-of-Network) In-Network POMCO/PHCS/Multiplan Out-of-Network Medical supplies Deductible plus Deductible plus Prosthetic devices Deductible plus Deductible plus Prescription medicines Covered through Express Scripts Covered through Express Scripts 1 Coverage requires the employee to pay an annual deductible before any other cost sharing is determined. The annual in-network deductible is $200 per individual with a maximum of $400 for a family. The annual out-of-network deductible is $300 per individual with a maximum of $1,000 for a family. After the annual deductible is satisfied, the employee must pay the, if applicable. The is then applied to the balance of the allowable amount. For out-of-network services, the employee is also responsible for the difference between the provider s charge and the allowable amount based on participating providers in the POMCO network. 2 Out-of-pocket maximum refers to the maximum amount of out-of-pocket expenses an employee would pay in a calendar year. The out-of-pocket expenses are defined as the deductibles and amounts, exclusive of amounts for prescription medicines. The differences between provider charges and the allowable amounts under the out-of-network level are not subject to the out-of-pocket maximum. Each medical program is governed by the plan document. If there is any difference between the information on these summary sheets and the plan document, the plan document will rule. Page 26 January 2015

29 Prescription Drugs Annual Deductible Out-of-Pocket Maximum No Deductible $2000 single/$4000 family Retail Generic Retail Brand Formulary Retail Brand Non-Formulary 15% * 25% 40% Mail Generic Mail Brand Formulary Mail Brand Non-Formulary Lesser of $15 or 15% * Lesser of $45 or 25% Lesser of $90 or 40% Specialty Mail Order (All) Same as Mail Order except 30 day supply Contraceptives Follows above schedule for retail and mail order *Generic Prescription Drugs: $0 copay (Certain Age/Gender Restrictions Apply) Smoking Cessation Drugs Women s Contraceptives Folic Acid Aspirin Fluoride Iron Supplements Vitamin D Supplements Preparatory Prescriptions associated with Colonoscopies Page 27 January 2015

30 GROUP DENTAL & VISION INSURANCE Upon employment, Syracuse University offers dental and vision coverage that is administered through Delta Dental and Vision Service Plan (VSP) respectively. There are two dental plan options to choose from: Preventive and Comprehensive. Enrollment in the dental plan with or without vision is a two-year commitment. The vision benefit is tied to your dental plan and is not available as a separate option Monthly Employee Contributions for Dental With or Without Vision Preventive Preventive Plus Vision Comprehensive Comprehensive Plus Vision Employee $8.89 $14.02 $30.33 $35.46 Employee + Spouse/ Domestic Partner $21.77 $32.05 $70.16 $80.44 Employee + Child(ren) $24.58 $35.72 $69.30 $80.44 Employee + Spouse/ Domestic Partner + Child(ren) $40.60 $58.40 $ $ Contributions listed here are based on the 12-month calendar year. The actual deduction from your paycheck depends on your deduction cycle. Contributions for domestic partners and their children are paid on an after-tax basis. Service Employees Benefit Fund Dental & Vision Plans Employees represented by the SEIU bargaining unit have the choice of participating in either the University s dental with or without vision plan as identified above, or the Service Employees Benefit Fund (SEBF) dental with or without vision plan. The SEBF plan is administered by the union and coverage is provided through SEBF Dental and Davis Vision respectively. Enrollment in the SEBF plan is a one-year commitment. The vision benefit is tied to your dental plan and is not available as a separate option Monthly Employee Contributions for SEBF With or Without Vision Basic Basic Plus Comprehensive Comprehensive Plus Vision Vision Employee $13.68 $18.09 $18.85 $23.26 Employee + 1 $28.97 $38.87 $33.13 $43.03 Family $42.41 $52.31 $49.15 $59.05 Contributions listed here are based on the 12-month calendar year. The actual deduction from your paycheck depends on your deduction cycle. Contributions for domestic partners and their children are paid on an after-tax basis. Page 28 January 2015

31 SUMMARY OF UNIVERSITY DENTAL BENEFITS Syracuse University offers the Delta Dental PPO SMi plan ( PPO plan ) underwritten and administered by Delta Dental of New York, Inc. ( Delta Dental ). You can visit any licensed dentist under this PPO plan, but you ll maximize plan value by using a PPO dentist. PPO dentists have agreed to accept PPO contracted fees, or reduced rates, and can t balance bill you for additional fees. The PPO plan includes an added cost-savings safety net the Delta Dental Premier 1 network ( Premier ). Premier is the nation s largest dental network with more than 80% of dentists nationwide ii and is the next best option if you can t find a PPO dentist. Premier dentists contracted fees are moderately higher than PPO dentists contracted fees; however, they will not bill you above their contracted fees, so you will usually save more compared to a non-participating dentist. LIMITATIONS AND EXCLUSIONS Certain limitations and exclusions apply. iii For example, non-covered services include: appearance only, preventive plaque control programs and Orthodontics. Additionally, procedures provided or devices started prior to the date you are eligible to receive services or prior to the plan s effective date are not covered. PRE-TREATMENT ESTIMATE If your proposed cost of dental care exceeds $300, Delta Dental recommends that you ask your dentist to request a pre-treatment estimate from them before you agree to receive the prescribed treatment. The pre-treatment estimate provides you up-front with an estimate of what will be paid by the Plan and the difference you will need to pay based on your plan benefits. Additionally, they can calculate how your plan s deductible, and maximums will affect your share of the cost of treatment. Pre-treatment estimates usually take about two to three weeks and are valid for 365 days. iv ONLINE SERVICES Visit Delta Dental s website at deltadentalins.com to locate participating dentists by location, specialty and network type; obtain eligibility and benefit information; check the status of a claim or see if your current dentist is a participating dentist. No online access? A Delta Dental Customer Service representative is available to assist you at Page 29 January 2015

32 PAYMENT FOR SERVICES The chart below illustrates payment responsibilities based on your choice of dentist. Delta Dental PPO Dentist Delta Dental Premier Dentist Non-Participating Dentist Plan Allowance Dentists are paid PPO contracted fees. Your costs are usually lowest. Dentists are paid Premier contracted fees. Your costs are usually moderate. Claims for services provided by non-participating dentists will be processed using a maximum fee level that may be higher than Delta Dental s maximum plan allowance. Your costs are usually highest. Payment Responsibilities By agreement, participating dentists must accept contracted fees as payment in for covered services. Delta Dental s benefit is a percentage of the maximum plan allowance, which may require a amount. Deductibles may also apply. You are also responsible for costs related to services that are not covered. The benefit payment is sent directly to you. v You are responsible for any applicable and/or deductibles, plus any difference between Delta Dental s payment (the maximum plan allowance) and the amount billed that exceeds this allowance. You are also responsible for costs related to services that are not covered. Benefits Summary Under the Delta Dental Plans: Plan Annual Deductible Per Person Family Deductible Deductible for Diagnostic and Preventive Services Annual Maximum Per Person Preventive $0 $0 Waived $500 Comprehensive $50 (does not apply to preventive services) $150 (does not apply to preventive services) Waived $2,000 The chart on the following page illustrates for each covered procedure in accordance with Delta Dental s payout level. Page 30 January 2015

33 Service ix Examples of Covered Services Delta Dental PPO Dentist vi Paid by Delta Dental Paid by Patient Preventive Plan Coverage Delta Dental Premier Dentist vii Paid by Delta Dental Paid by Patient Non-Participating Dentist viii Paid by Delta Dental Diagnostic Exam & x-rays 100% 0% 100% 0% 100% 0% Preventive TMJ Fluoride treatments (to age 19), teeth cleaning, sealants (to age 14) Temporomandibular joint dysfunction treatment Paid by Patient 100% 0% 100% 0% 100% 0% 50% 50% 50% 50% 50% 50% Additional Coverage for Comprehensive Plan Only Basic Fillings 80% 20% 60% 40% 60% 40% Restorative Oral Surgery Extractions 80% 20% 60% 40% 60% 40% Endodontics Root canal therapy 80% 20% 60% 40% 60% 40% Periodontics Treatment of gum disorders 80% 20% 60% 40% 60% 40% Prosthodontics Dentures, bridgework 50% 50% 50% 50% 50% 50% Major Restorative Stainless Steel Crowns Crowns 50% 50% 50% 50% 50% 50% On temporary teeth (only for children) 80% 20% 60% 40% 60% 40% 1 Delta Dental PPO and Delta Dental Premier are open networks that allow enrollees to visit any licensed dentist, either in the PPO network, where you will save the most on out-of-pocket costs, the moderate cost Premier network or outside the Delta Dental network, where there are no cost protections. Enrollees who visit a network dentist receive the advantages of no billing beyond the charges allowed by the plan and the submission of claims by dentists. In Texas, Delta Dental Insurance Company offers Dental Provider Organization (DPO) plans. 2 NetMinder Dental Network Trend Report, March Please refer to your plan booklet and corresponding attachments for a complete list of your plan s services, limitations and exclusions. 4 Pre-treatment estimates are typically valid for 365 days. Please refer to your plan booklet for your plan s benefits, limitations and exclusions. 5 Unless your plan allows you to assign the benefits to your dentist Reimbursement is based on PPO contracted fees for PPO dentists, Premier contracted fees for Premier dentists and the maximum plan allowance for non-participating dentists. Percentage is based on Delta Dental s allowance or the dentist s actual fee, whichever is less (allowed amount). Delta Dental s payment under the plan, plus the patient payment, equals the allowed amount, which is accepted by Delta Dental participating dentists as payment. Participating dentists are paid directly by Delta Dental and, by agreement, cannot bill you more than the applicable, deductible or charges where maximums have been exceeded for covered services. By selecting a participating dentist, you can limit your out-ofpocket costs. For services performed by non-participating dentists, Delta Dental sends the benefit payment directly to you. You are responsible for paying the non-participating dentist s submitted fee, which may include amounts in addition to your share of Delta Dental s allowed amount. 6 Limitations and/or waiting periods may apply for some benefits; some services may be excluded from your plan. Please refer to your plan booklet and corresponding attachments for a complete list of your plan s services, limitations and exclusions. Page 31 January 2015

34 SUMMARY OF UNIVERSITY VISION BENEFITS The following is a summary of vision services and benefits provided through VSP: Coverage Frequency Co-pay Plan Information Exam Prescription Glasses (lenses) Every calendar year Every calendar year $15 Routine exam only $25 Single vision, lined bifocal, and lined trifocal lenses Polycarbonate lenses for dependent children Prescription Glasses (frames)* Every other calendar year n/a $150 allowance for frame of your choice 20% off the amount over your choice Lens Options Every calendar year $55 $95-$105 $150-$175 Standard progressive lenses Premium progressive lenses Custom progressive lenses Contact Lens Care* Every calendar year up to $60 $130 allowance for contacts. Copay applies to contact lens exam (fitting and evaluation). If you choose contact lenses you will be eligible for a frame one calendar year from the date the contact lenses were obtained. Current soft contact lens wearers may qualify for a special program that includes a contact lens exam and initial supply of replacement lenses. Additional Coverage Diabetic Eyecare Plus Program Extra Discounts and Savings Glasses and Sunglasses Laser Vision Correction 20% off additional glasses and sunglasses, including lens options, from any VSP doctor within 12 months of your last Well Vision Exam Average 15% off the regular price or 5% off the promotional price. Discounts only available from contracted facilities. If you see a non-vsp provider, you ll receive a lesser benefit. Before seeing a non-vsp provider, call VSP at for more details. Out-of-Network Reimbursement Amounts: Exam... Up to $45 Lined trifocal lenses... Up to $65 Single vision lenses... Up to $30 Frame... Up to $70 Lined bifocal lenses... Up to $50 Contacts... Up to $105 Progressive lenses. Up to $50 *Either frames or contact lenses are covered in a calendar year. If you choose contact lenses, you will be eligible for a frame one calendar year from the date the contact lenses were obtained. Page 32 January 2015

35 Flexible Spending Accounts (FSA) Flexible spending accounts allow you to set aside a portion of your salary (pre-tax dollars) for you and your eligible dependents (as defined by the Internal Revenue Code and the University s Cafeteria Plan) to assist with paying health care and dependent care expenses. The advantages of Flexible Spending Accounts are that you do not pay any federal, state, or social security (FICA) taxes on the money you contribute to it. The taxes you save and the effect on your paycheck will depend on your personal situation (e.g., your household income, tax bracket, and the amount you contribute to the account). The University s FSA benefits are administered through WageWorks. The Health Care Flexible Spending Account allows you to set aside pre-tax dollars for eligible health care expenses that are not covered as eligible medical or dental expenses under any other health plan. Your entire annual contribution is available upon enrollment for services incurred as of your enrollment date (date of hire) through December 31. Please note that expenses for your domestic partner or his or her children will not be eligible for reimbursement under your Health Care FSA unless they qualify as your dependents for federal income tax purposes. You can contribute from $100 to $2,550 annually to this account, automatically deducted in equal installments from your paychecks before taxes are calculated. Total individual contributions cannot exceed $2,550. Health Care FSA participants may carry over up to $500 in unused funds from one year to the next. This means any money, up to $500, left unspent in your Health Care FSA as of December 31 may be used to reimburse you for eligible expenses incurred during the following calendar year. Any money carried over from one year to the next does not count toward the annual maximum amount ($2,550) you may contribute to your health care FSA in the new year. The Dependent Care Flexible Spending Account offers tax savings on eligible dependent (child or elder) care expenses provided by qualified caregivers. The services must be incurred to enable you, or you and your spouse if you are married, to work or attend school time. The amount to be reimbursed must not be greater than your income or the combined income of an employee and spouse, whichever is lower. Services must be for the physical care of the child, not for education, meals, etc. Unlike Health Care FSAs, Dependent Care FSAs are pay-as-you-go accounts; you cannot receive reimbursement for the amount of the annual contribution on day one. Participants can only be reimbursed up to their available balance (e.g., the amount they have had deducted during that plan year, less any reimbursements they have already received). You can contribute from $100 to $5,000 per household annually to this account, automatically deducted in equal installments from your paychecks before taxes are calculated. (The maximum limit is $2,500 each for married individuals filing separate returns.) There is no rollover permitted for unused Dependent Care FSA funds. IRS regulations require that you use the money in your Flexible Spending Accounts for Page 33 January 2015

36 eligible expenses incurred in the plan year during which the contributions are made. Note: Expenses are considered to be "incurred" when the service is provided, and not when you are billed for or pay for the expenses. Any remaining balance in excess of $500 for your Health Care FSA, or the entire excess amount remaining in your Dependent Care FSA at the end of the plan year will be forfeited. Therefore, it is important that you estimate your expenses carey before electing your contribution amount. FSA FREQUENTLY ASKED QUESTIONS Who can participate in an FSA? All Benefits Eligible Employees, as that term is defined by the University, can participate and submit expenses for their spouses and IRS eligible dependents, regardless of whether the employee or the dependent is enrolled in a University health care plan. What is the advantage of receiving reimbursement through my FSA instead of claiming these expenses on my tax returns? The IRS only permits you to deduct health care expenses meet or exceed 7.65% of your adjusted gross income. A Health Care FSA can be used for any amount (subject to the minimum contribution of $100). For dependent care, please consult your tax advisor or a WageWorks representative to see if it is more beneficial for you to take the dependent daycare credit or tax credit. Keep in mind the FSA will allow you to recover these funds much sooner. Do I have to participate in both the Health and Dependent Care Accounts? No, you may choose to participate in either account or both accounts. When can I change the amount I elect to contribute to these accounts? During the plan year you may change your contribution only if you experience a qualifying event such as marriage, divorce, birth, adoption or a change in employment status for you or your spouse. During each annual Open Enrollment period, you must elect the amount you wish to contribute for the next plan year. FSA elections do not carry forward automatically, as other benefit elections do. What happens if my employment terminates prior to the end of the plan year? You will have until April 30 of the year after you terminate to submit claims with dates of service that fall between your FSA effective date and your termination date. If participants wish to extend their eligibility for claims incurred after their termination date, they must elect FSA COBRA and continue to contribute to their FSA to keep their account(s) active. Any new contributions are made on an after-tax basis. Participants have until April 30 of the following calendar year to submit receipts to WageWorks for reimbursement. Page 34 January 2015

37 Can I submit items that I have purchased over-the-counter for reimbursement? The list of over-the-counter (OTC) items eligible for reimbursement has recently been amended. Please review the list on page {TBD} and contact WageWorks with any questions. Some OTC items are eligible for reimbursement when accompanied by a Certificate of Medical Necessity. What is a Certificate of Medical Necessity (CMN)? Under Internal Revenue Service (IRS) rules, some health care services and products are only eligible for reimbursement from your Health Care FSA when your doctor or other licensed health care provider certifies that they are medically necessary. Your provider must y complete the CMN to render the services eligible. You must submit a copy of the CMN prior to submitting your first reimbursement request for the specific service or product. If treatment extends beyond the time period listed, you will need to submit a new CMN detailing the new time period. Can I submit for claims incurred before my start date? No. Federal regulations prohibit payments for claims incurred prior to the period of coverage under the FSA. Can the FSA reimburse my Health Care or Dependent Care provider directly? No. The FSA cannot make a payment on your behalf. Can I get reimbursed for my contribution or my spouse s contribution to health insurance through my FSA? No. Premiums are not an eligible FSA expense. How do I file for reimbursement? WageWorks offers a variety of ways in which you can submit your health and dependent care expenses. You may complete a reimbursement form (available on the HR forms webpage), attach receipts or an Explanation of Benefits from an insurance company, and submit to the address or fax number listed on the reimbursement form. You can also submit your claims online at Automatic reimbursement for your health care copays and is another option as is the EZ Receipts app. More information on these options as well as helpful tools to maximize your FSA can be found online at What happens if I have not used all the money in my account by the end of the calendar year? Federal law dictates that money left in the Dependent Care FSA account at the end of the year is forfeited to your employer (commonly known as the use it or lose it provision). For the Health Care FSA, any amount in excess of $500 is forfeited to the University at the end of the year. Although you have until April 30 of the following year to submit your claims, the claims must be incurred before the end of the calendar year. We encourage you to file as early as possible since the claims must be received (not postmarked) by WageWorks by the April 30 deadline. Page 35 January 2015

38 Do I need receipts in order to receive reimbursement? Yes. Dependent Care claims require a receipt or a personal statement itemizing the charges from your provider. In addition, the statement must include the provider s name, address, tax identification number or Social Security number, date(s) of service, amount charged, a description of the service(s) rendered, and name of person receiving the service. Health Care should be accompanied by an Explanation of Benefits from your insurance carrier or, if the expense is excluded by insurance, a description or explanation of the charge and a cash register receipt. What is the maximum or minimum I can contribute to my FSA? Health Care FSA has a maximum of $2,550 and the Dependent Care FSA has a maximum of $5,000. They both have minimums of $100. In addition, the IRS maximum is $5,000 per family ($2,500 each for married couples filing separate returns) for Dependent Care reimbursement. Do I have to keep track of how much money is in my account during the year? No. WageWorks, our third party administrator, does it for you. You will receive a statement of your account balance from them with each reimbursement check or you can view your account online at or using the WageWorks app. Page 36 January 2015

39 FSA Eligible Healthcare Expenses Below is the list of items typically covered by a standard FSA. For a complete list visit Prescription Requirement for OTC Drug Purchases: A doctor s prescription is required in order to be reimbursed for over-the counter (OTC) drugs. OTC drugs requiring a prescription are indicated in the following list with the abbreviation (Rx). Acne treatments (over-the-counter) (Rx) Dental co-insurance Medical supplies (for treatment of a medical Acupuncture Dental co-payment condition) Adoption (medical expenses related to) Dental reconstruction (including implants) Medicines (over-the-counter) (Rx) Alcoholism treatment Dentures, bridges, etc. Medicines (prescription) Midwife Allergy & sinus medicine and products Diabetic monitor, test kits, strips and supplies Mileage (for travel to/from eligible (over-the-counter)(rx) Diagnostic services healthcare) Allergy medication (prescription) Diaper rash ointments and creams (Rx) Monitors & test kits (over-the-counter) Ambulance and emergency health services Drug addiction treatment Motion & nausea (over-the-counter) (Rx) Anesthesia (for non-cosmetic purposes) Drugs (prescription) Nasal sprays & strips (over-the-counter) (Rx) Antacid (over-the-counter) (Rx) Ear drops and wax removal (over-the-counter) (Rx) Non-prescription drugs and medicines Antibiotic ointment (over-the-counter) (Rx) Eye drops and treatments (over-the-counter) (Rx) (for non-cosmetic purposes) (Rx) Aspirin or other pain reliever Eye drops and treatments (over-the-counter) (Rx) Norplant insertion or removal (over-the-counter)(rx) Eye examinations Nursing services (wages and taxes) Asthma medicines or treatments Eye related equipment/materials OB/GYN fees (over-the-counter)(rx) Eye surgery or treatment to correct vision Occlusal guards to prevent teeth grinding Athletic treatments / braces Occupational therapy Eyeglasses (over-the-counter & prescription) Bandages and related items (over-the-counter) (related to a medical condition or disability) Fertility monitor (over-the-counter) Birth control (over-the-counter) (Rx) Office visits (chiro, dental, medical, psych/ Fertility treatment (for employee, spouse or therapy, vision) Birth control (prescription) dependent) Operations (for non-cosmetic purposes) Blood pressure monitor First aid kit (over-the-counter) Operations (for vision and dental) Body scans Flu shots Optometrist / ophthalmologist fees Braille books & magazines (difference in cost only) Gastrointestinal medication (over-the-counter) (Rx) Organ transplants (recipient and donor) Breastfeeding classes Guide dog (dog, training, care) Orthotics Breast pumps (for a lactating woman) Hearing aids and batteries Ortho keratotomy Canker & cold sore treatments (over-the-counter) Hospital services and fees Orthodontia (braces and retainers) (Rx) Immunizations Orthopedic & surgical supports Chest rubs (over-the-counter) (Rx) Incontinence supplies Over-the-counter bandages and related Childbirth classes (charges for mother only) items Infertility treatment (for employee, spouse or Chiropractic office visit or treatment Over-the-counter healthcare products (Rx) dependent) Over-the-counter drugs and medicines Cholesterol test kits and supplies Insulin, testing materials and supplies (including for motion sickness, sleep aids Christian Science practitioners Laboratory fees and sedatives) (Rx) Co-insurance (dental, medical, prescription, vision) Lactose intolerance (over-the-counter) (Rx) Over-the-counter products for dental, oral Co-payment (dental, medical, vision) Lamaze classes (charges for mother only) and teething pain (Rx) Cold & flu medicine (over-the-counter) (Rx) Laser eye surgery Over-the-counter vision products Concierge medical fees Lasik Ovulation monitor (over-the-counter) (billed for actual services received) Laxatives (over-the-counter) (Rx) Oxygen Page 37 January 2015

40 FSA Eligible Healthcare Expenses Cont. Condoms Learning disability treatments Pain reliever (over-the-counter) (Rx) Contact lenses and solutions Lice treatment (over-the-counter) (Rx) Parental fees (billed for actual services Contraceptives (over-the-counter) (Rx) Listening therapy received for disabled children) Corn and callus remover (over-the-counter) (Rx) Physical exams Corneal keratotomy Mastectomy-related special bras Physical therapy Cough drops, cough syrup, sore throat lozenges Medical abortion Pregnancy tests (over-the-counter) over-the-counter) (Rx) Counseling (for treatment of a medical condition) Medical co-insurance Prescription co-insurance Crutches, canes, walkers or like equipment Medical co-payment Prescription co-insurance (purchase or rental) Deductible for dental, medical, prescription and vision plans Medical equipment (for treatment of medical condition) and repairs Medical monitoring and testing devices Dental care (for non-cosmetic purposes, including sealants) Medical records charges Prosthesis Prescription drugs (for non-cosmetic purposes) Propecia (for treatment of a medical condition) Psychiatric care Sterilization Vaccinations Psychoanalysis Student health fees billed for actual services Varicose vein removal surgery (for medical received (dental, medical, prescription, vision) care) Psychologist fees Vasectomy Radial keratotomy (RK) Sunglasses (prescription) Viagra and similar prescription medications Reading glasses (over-the-counter) Sunscreen with SPF 15+ and broad spectrum, Vision co-insurance Removal of benign mole, cyst or tumor sunburn creams & ointments (over-the-counter) Vision co-payment Surgery (for non-cosmetic purposes) Retin-A (for non-cosmetic purposes) Vitamins (prescription) Teeth grinding prevention devices Walking aids (canes, walkers, crutches and Sales tax, shipping and handling fees related supplies) (for any eligible expenses) Therapy (for treatment of a medical condition) Wart removal treatments (over-the-counter) Smoking cessation (programs, counseling) Toothache and teething pain relievers (over-the- (Rx) Smoking cessation drugs (prescription) counter) (Rx) Weight loss drugs (for treatment of a medical condition) (Rx) Smoking cessation gum or patches (over-thecounter) (Rx) Transportation, parking & related travel expenses (essential to receive eligible care) Wheelchair and repairs Speech therapy Tubal ligation Wound care (over-the-counter) Spermicidals (Rx) Urological products X-ray fees (dental, medical) Page 38 January 2015

41 FSA Maybe Eligible Healthcare Expenses: Certain expenses require additional information in order to determine if they qualify. Products and services classified as Maybe require a written statement from your healthcare provider indicating (1) the diagnosis and (2) the medical necessity of the expense. Specialized items also require proof of the difference in cost: (1) the cost of standard, unmodified item, and (2) the cost of special or modified item. If you incur an expense that is classified as Maybe, you will need to submit the above documentation with your claim. Allergy treatments and products Dietary supplements* Nutritional supplements* Alternative dietary supplements* Doula or birthing coach Orthopedic shoes and inserts (difference in Dyslexia treatment cost only of specialized orthopedic shoe over like non-specialized shoe) Alternative drugs, medicines and treatment products* Alternative healers* Breast reconstruction surgery (following mastectomy) Car modifications* Cord blood storage (for future treatment of a birth defect or known medical condition) Cosmetic procedures or surgery for birth defects, accidents, and/or disease Exercise equipment or program* Fitness programs* Health club dues* Herbal or homeopathic medicines (over-the-counter) Home improvements* Humidifier, air filter and supplies Lodging (limited to $50 per night for patient to receive medical care and $50 per night for one caregiver) Reconstructive surgery (following accident or medical procedure or condition) Special equipment Special foods (gluten-free, salt-free or other for treatment of a medical condition; difference in cost only) Special school (for mental and physical disabilities) Swimming lessons* Dancing lessons* Transgender treatments / surgery Magnetic therapy (over-the-counter) Tuition or educational classes* Dental veneers Massage therapy* Weight loss counseling Dermatology treatments and products Modified equipment (difference in cost only) Weight loss program* * As treatment or required for a medical condition diagnosed by a licensed healthcare professional. Eligible Dependent Care Expenses Adult day care center After school program Au pair Babysitting (work-related, in your home or someone else s, but not provided by your own dependent) Before- or after-school program Child care Custodial elder care (work-related) Dependent care (while you work, to enable you to work or look for work) Educational services (for preschool, but no kindergarten or above) Elder care (in your home or someone else s) Extended care (supervised program before or after school) Housekeeper who cares for child (only portion of payment attributable to work-related child care) Nanny Nursery school Payroll taxes related to eligible care Preschool Registration fees (required for eligible care, after actual services are received) Senior day care Sick child care Summer day camp (but not overnight camp) Transportation to and from eligible care (provided by your care provider) For a child under the age of 13 or other dependents who are physically and mentally incapable of taking care of themselves WageWorks, Inc. All rights reserved. FSA-EXPENSE-FLY (OCT 2013) Page 39 January 2015

42 THE UNIVERSITY WELLNESS INITIATIVE Syracuse University is dedicated to offering faculty and staff opportunities to positively affect their own health and well-being. The University Wellness Initiative reflects SU s ongoing commitment to provide a healthy environment for the entire campus community. With embody: your well-being, your way, the Initiative pursues a broad, integrated approach to improving campus wellness that enables individuals to chart their own course to a healthy life. A cornerstone in this effort is a partnership with Optum, a leading health services company. You can create personalized wellness programs, take a Health Risk Assessment, or access health news and information through MyOptumHealth.syr.edu. You can also speak with a nurse 24/7 about health concerns, questions or decisions by calling NurseLine at Other Optum programs offered as enhancements to the University health plan will help members manage chronic conditions such as asthma, coronary artery disease, COPD and diabetes. And there is more to embody. In addition to integrating with Optum, embody leverages a rich array of health promotion resources on campus and beyond to empower faculty and staff to achieve personal wellness goals. A website wellness.syr.edu is an interactive one-stop shop for events, health news, research, the University s Wellness Catalog, and other wellness resources. Offerings such as healthy cooking classes, active family events, and stress-management programs, among others, will provide many opportunities to pursue your well-being, your way. These programs and services offer University faculty and staff new ways to engage with health professionals and resources that can make a real impact on their health and wellbeing, while also reducing health care costs for individuals and the University. Page 40 January 2015

43 GROUP LIFE INSURANCE Upon employment, Syracuse University provides $50,000 basic group life insurance at no cost for faculty and $10,000 basic group life insurance at no cost for staff employees. This coverage reduces to $32,500 for faculty and $6,500 for staff at age 65. All life and AD&D insurance is administered through MetLife. SUPPLEMENTAL LIFE INSURANCE Upon employment, Syracuse University offers you the opportunity to purchase additional life insurance in increments of one to ten times your annual salary, not to exceed $2,000,000. Proof of insurability is required if you elect supplemental life coverage above $250,000, or for any increase in supplemental life insurance after new hire enrollment Monthly Employee Contributions for Supplemental Life Insurance Age Cost per $1,000 per Month* Under age 25 $ through 29 $ through 34 $ through 39 $ through 44 $ through 49 $ through 54 $ through 59 $ through 64 $ through 69 $ $ 2.26 *Contributions listed here are based on the 12-month calendar year. The actual deduction from your paycheck depends on your deduction cycle. ACCIDENTAL DEATH AND DISMEMBERMENT (AD&D) INSURANCE Upon employment, Syracuse University provides $3,000 basic AD&D coverage at no cost to you. SUPPLEMENTAL ACCIDENTAL DEATH/DISMEMBERMENT (AD&D) INSURANCE Upon employment, Syracuse University offers you the opportunity to purchase additional AD&D coverage in increments of one to ten times your annual salary. Total coverage must not exceed the amount of supplemental life insurance. The monthly cost is $.02 per thousand dollars of coverage. Page 41 January 2015

44 Will Preparation Service Life Insurance coverage and Will Preparation Service you may need. If you choose to enroll in supplemental life insurance, you have access to another service to protect the ones you love Will Preparation. 1 Having an up-to-date will is one of the most important things you can do for your family. Like life insurance, a carey prepared will is important. With a will, you can define your most important decisions such as who will care for your children or inherit your property. The Will Preparation Service also includes the preparation of living wills and power of attorney. By enrolling for supplemental life coverage, you will have access to Hyatt Legal Plans network of more than 12,000 participating attorneys for preparing or updating these documents at no additional cost to you if you use a Hyatt Legal Plans participating attorney. It s easy to use the Will Preparation Service. Once your supplemental life coverage becomes effective, you will receive information that will allow you to access the Will Preparation Service. Step 1: Call Hyatt Legal Plans toll-free number, , and a client service representative will assist you in locating a participating plan attorney in your area and provide you with a case number. Step 2: Call and make an appointment with a participating attorney many plan attorneys have evening and weekend appointments for your convenience. Step 3: That s it. When you use a plan attorney, you do not need to submit any claim forms. You also have the flexibility of using a non-network attorney and being reimbursed for covered services according to a set fee schedule. 2 Supplemental Life Insurance and Will Preparation Service are two important ways to protect yourself and the ones you love. 1 Will Preparation Services are offered by Hyatt Legal Plans, Inc., Cleveland, Ohio. In certain states, legal services benefits are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and affiliates, Warwick, Rhode Island. For New York-sitused cases, the Will Preparation Service is an expanded offering that includes office consultations and telephone advice for certain other legal matters beyond Will Preparation. 2 If you chose a non-network attorney, you will be responsible for any attorneys fees that exceed the reimbursed amount. Page 42 January 2015

45 What is the Will Preparation service? Who is eligible to participate in the Will Preparation service? What s included? Are ancillary documents covered? Is there a fee charged to the Plan? Is there a limit to the number of times a will can be updated? How often should I review and update my will? Frequently Asked Questions Will Preparation, 1 part of a robust continuum of value-added services, is a living benefits feature offering face-to-face and telephone consultations to employees through Hyatt Legal Plans Inc., a MetLife company, as a part of MetLife s Group Life Plans. This service y covers attorney fees for preparing and updating a will when using a participating plan attorney. Employees who participate in MetLife s Group Variable Universal Life, Group Universal Life or Supplemental Term Life Plans are eligible. 2 Will Preparation provides participants in a MetLife Group Life Plan access to attorney services to complete the entire process of creating and updating a will. Highlights include: Full-service options to prepare and update wills, including complex wills and codicils, living wills and powers of attorney, for both you and your spouse/domestic partner. Face-to-face and telephone consultations with a Hyatt Legal Plans participating plan attorney. Unlimited access to update a will for as long as you continue to participate in the MetLife Group Life Plan. Plus: Convenient access to a local attorney. Hyatt s network of over 12,000 participating plan attorneys. Hyatt s award-winning Client Service Center to assist in locating an attorney. 3 All living wills, codicils, testamentary trusts and powers of attorney are included. This service does not include fees associated with living trusts and tax planning needs. However, the participating plan attorney can provide guidance on living trusts and how to approach tax issues related to a will. If you or your spouse/domestic partner choose to have a living trust created, the participating plan attorney will provide a written fee statement detailing any associated costs in advance. Will Preparation Service is an option included in MetLife s Group Variable Universal Life, Group Universal Life or Supplemental Term Life coverages at no additional cost to employers, employees and their spouses/domestic partners. No. As long as you participate in the MetLife Group Plan, you and your spouse/ domestic partner can consult face-to-face and via telephone with a participating plan attorney as often as you deem necessary to keep your will, living will and power of attorney up-to-date. You should review your will every 5 to 10 years with an attorney. It is prudent to review a will, living will and power of attorney whenever a life-changing event occurs such as: marriage, divorce, birth of a child, etc. Page 43 January 2015

46 How do I access this service? Can I use an attorney outside Hyatt Legal Plans network? It s easy and convenient for you to access this service: You can call a toll-free telephone number, , to speak with a Hyatt Legal Plans Client Service Representative. You will need to provide your company name, group number (if available) and the last 4 digits of your Social Security or Employee number. Client Service Representatives assist you in locating participating plan attorneys in the requested location, and provide you with case numbers to give to the participating plan attorney of your choice. When using a participating plan attorney, no claim forms or co-payments are required the attorney handles all the paperwork. Yes. If you choose to use an attorney who does not participate in the Hyatt Legal Plans network, you will receive reimbursement for covered services according to a set fee schedule. Once Hyatt is notified that an out-of-network attorney has been chosen, you will receive a claim form and information material, including a Fee Reimbursement Schedule. In this case, you will be responsible for any attorney fees that exceed the reimbursed amount. Are there any hidden fees or charges associated with this service? Does my spouse/domestic partner need a joint will with me in order to take advantage of this service? Am I responsible for storing the executed documents? What are my options if I am not satisfied with the service provided by a participating plan attorney? No. All attorney fees, when using a participating plan attorney, for preparing and updating a will, living will and power of attorney are covered under the Will Preparation Service. However, if the attorney receives a request to provide additional work that is not y covered under this service, the attorney will provide a written fee statement detailing any associated costs in advance. No. You and your spouse/domestic partner will be able to prepare your own separate wills with a participating plan attorney. If after discussing your needs, a joint will is desired and is recommended by the attorney and allowed in the state, one can be prepared. Yes. Upon completion of your will, you will be provided with the original will by the attorney. It is your sole responsibility to store the will in a safe place. The participating plan attorney will provide you with advice on how to properly store the will. Hyatt Legal Plans carey screens and manages its network of participating plan attorneys on a regular basis. If you are dissatisfied with the service provided by a participating plan attorney, you should notify Hyatt. Hyatt will work to resolve any issues to your satisfaction. An out-of-network option is also available, if you prefer to utilize an attorney who does not participate in Hyatt Legal Plans network. 1 Will Preparation and Estate Resolution Services are offered by Hyatt Legal Plans, Inc., Cleveland, Ohio. In certain states, legal services benefits are provided through insurance coverage underwritten by Metropolitan Property and Casualty Insurance Company and affiliates, Warwick, Rhode Island. For New York-sitused cases, the Will Preparation service is an expanded offering that includes office consultations and telephone advice for certain other legal matters beyond Will Preparation. 2 Domestic Partner coverage is available when offered by the employer and approved in the employer s situs state Smart Business World Class Customer Service Awards, Winner of the Service Standards category International Business Awards, Customer Service Department of the Year: Distinguished Honoree. For more information and schedule of fees, please visit: Page 44 January 2015

47 DEPENDENT LIFE INSURANCE: Spouse/Same-Sex Domestic Partner Life insurance may be purchased for your spouse/same-sex domestic partner in an amount not to exceed your own combined basic and supplemental life coverage. Coverage for your spouse/same-sex domestic partner may be elected in the amounts of $10,000 and $20,000 without providing a Statement of Health. Coverage levels of $40,000, $60,000, $80,000 and $100,000 may also be elected; however your spouse/same-sex domestic partner must complete and submit a Statement of Health form and have it approved by MetLife. Coverage will not go into effect until MetLife notifies Human Resources of its approval Monthly Employee Contributions for Spouse/Same-Sex Domestic Partner Life Insurance Age Cost Per Thousand Per Month* Under age 25 $ through 29 $ through 34 $ through 39 $ through 44 $ through 49 $ through 54 $ through 59 $ through 64 $ through 69 $ $2.26 *Contributions listed here are based on the 12-month calendar year. The actual deduction from your paycheck depends on your deduction cycle. DEPENDENT LIFE INSURANCE: CHILD(REN) Life insurance may also be purchased for your child(ren) in the amount of $10,000 as long as this coverage does not exceed your own. A Statement of Health is not required. Dependents can be covered by multiple SU employees. The monthly premium is $.63 and remains the same regardless of the number of children covered. Page 45 January 2015

48 Disability Benefits Plan for EXEMPT Employees SALARY CONTINUATION Upon employment, the Syracuse University Salary Continuation Plan for faculty and exempt (salaried) employees provides benefits for qualifying short-term disabilities, maternity leaves, and long-term disabilities. There is no employee contribution required. Period of Disability Weeks 0-16 Weeks Weeks Weeks 53+ Benefits Paid by SU (taxable) 100% of current salary 60% of current salary 50% of current salary 50% of current salary if Social Security disability award has been granted before Week 53, and if the eligible employee has completed at least 12 months of active employment DISABILITY BENEFITS PLAN FOR NON-EXEMPT EMPLOYEES Syracuse University provides income replacement in excess of Statutory New York State Disability Benefits for a non-exempt (hourly) employee absent from work due to nonoccupational injury or illness. Syracuse University provides the following benefits. There is no employee contribution required. Period of Disability Weeks 0-1 Weeks 2 26 Benefits Paid by SU (taxable) 1 st week waiting period (5 consecutive days), sick pay benefits payable if eligible New York State Statutory benefits up to a maximum of $ if eligible. Supplemental Benefit up to a maximum of $170.00, if eligible. WORKERS COMPENSATION Syracuse University provides required coverage for all employees, on a non-contributory basis, for protection for occupational illness or injury. Page 46 January 2015

49 VOLUNTARY LONG TERM DISABILITY INSURANCE The Voluntary Group Long Term Disability Plan (LTD), insured by The Standard, is designed to pay a monthly benefit to you in the event you cannot work because of a covered illness or injury. According to The Standard, this benefit replaces 60% of an employee s income if he/she is disabled for more than 6 months. The benefit payments are not taxable. Premiums are paid entirely by the employee. Voluntary LTD insurance helps protect you and your lifestyle and further helps you to meet your financial commitments in a time of need. The advantages to you include: Convenience. With premiums deducted directly from your paycheck after-tax, you don't have to worry about mailing monthly payments. Savings. Typically, group insurance rates are lower than the rates of individual insurance plans, generally providing you with coverage at a lower cost. Peace of Mind. You can take comfort and satisfaction in knowing that you have taken a step toward planning for your income replacement needs during a period of disability. Do I need LTD insurance? If you are not certain that you need LTD coverage, consider if you will be able to meet your financial obligations if you become disabled and are unable to work for an extended period of time. How much is the LTD benefit amount? The monthly LTD benefit is 60% of insured pre-disability earnings, reduced by deductible income. The plan s minimum benefit is $100 monthly, and the maximum is $12,000 monthly. How is the LTD benefit amount calculated? The LTD benefit amount is determined by multiplying your insured pre-disability earnings by the specified benefit percentage. This amount is then reduced by other income you may receive or are eligible to receive while LTD benefits are payable, including but not limited to, Social Security disability benefits. This other income is referred to as deductible income. Under the terms of the group policy, insured employees will pay the premiums for this coverage with after-tax dollars. As a result, under current federal tax law, the LTD benefit would not be subject to federal income tax. Please refer to the plan document and booklet for further information including an explanation of pre-disability earnings and deductible income. If an employee is covered under both the Voluntary LTD insurance and the University s Salary Continuation Plan, disability benefits shall first be provided under the Voluntary LTD insurance. To the extent an employee is eligible for any payments Page 47 January 2015

50 under the Salary Continuation Plan, such payments shall be reduced by the value of any payments that the employee is eligible for under the Voluntary LTD insurance. The preceding two sentences shall also apply to any successor plan to the group policy and/or the Salary Continuation Plan, except to the extent the terms of the successor plan expressly provide otherwise. Will I have to provide information regarding my medical history? If you apply for Voluntary LTD insurance during your first 45 days of benefit eligibility you will not be required to submit evidence of insurability and you will qualify to insure monthly pre-disability earnings up to a maximum amount of $20,000. However, if you are eligible to enroll during this period and elect not to, satisfactory evidence of insurability will be required during the next Open Enrollment Period should you wish to elect the benefit at that time. You will need to complete and submit a Medical History Statement and, in some cases, may be requested to supply additional medical information and/or a physical exam. When do LTD benefits become payable? If you become disabled and your claim for LTD benefits is approved by The Standard, LTD benefits become payable after you have been continuously disabled for 180 days and remain continuously disabled. LTD benefits are not payable during this benefit waiting period. When am I considered disabled? During the benefit waiting period (six months from the date you become disabled) and the own occupation period*, you are considered disabled if, as a result of physical disease, injury, pregnancy, or mental disorder: You are unable to perform with reasonable continuity the material duties of your own occupation; and You suffer a loss of at least 20% of your indexed pre-disability earnings when working in your own occupation. Note: You are not disabled merely because your right to perform your own occupation is restricted, including a restriction or loss of license. After the own occupation period, you are considered disabled if, as a result of physical disease, injury, pregnancy, or mental disorder, you are unable to perform with reasonable continuity the material duties of any occupation that you are able to perform, whether due to education, training, or experience: Which is available at one or more locations in the national economy; and In which you can be expected to earn at least 60% of your indexed pre-disability earnings within 12 months following your return to work, regardless of whether you are working in that or any other occupation. Page 48 January 2015

51 *The own occupation period for the Voluntary LTD coverage is the first 24 months for which LTD benefits are paid. You may work in another occupation while you are disabled from your own occupation; however, you will not be considered disabled when your work earnings from another occupation meet or exceed 80% of your indexed pre-disability earnings. When do LTD benefits end? LTD benefits end automatically on the earliest of: The date you are no longer disabled; The date your maximum benefit period ends (age 65, or later if disabled after age 61½); The date you die; The date benefits become payable under any other LTD plan (excluding the Syracuse University Salary Continuation Plan) under which you become insured through employment during a period of temporary recovery; and The date you fail to provide proof of continued disability and entitlement to LTD benefits. What are some of the other features of this coverage? This LTD coverage has the following features: It covers disabilities that occur 24 hours a day, both on and off the job. Because premium payments are made with after-tax dollars, LTD benefit payments are federally income tax-free under current federal tax law. If Syracuse University makes an approved worksite modification that enables you to return to work while disabled, The Standard will reimburse Syracuse University up to a pre-approved amount for some or all of the cost of the modification. While LTD benefits are payable, you may qualify to participate in a rehabilitation plan that prepares you to return to work. If you qualify, The Standard may pay for return to work expenses you incur such as job search, training and education, and family care expenses. If you die while LTD benefits are payable, and on the date you die you have been continuously disabled for at least 180 days, a survivors benefit equal to three times your unreduced monthly LTD benefit may be payable. Employees who enroll in this plan also have access to certain employee assistance services free of charge. These services include access to 24/7 telephonic counseling from a master s-degreed clinician who can also provide referrals if longer term counseling is appropriate. You also will have access to online resources such as videos, webinars and a live-chat feature. These services are available for the individual enrolled in LTD as well as his or her household members and dependents, including those living away from home (up to age 26). These services complement to our Syracuse University Faculty and Staff Assistance Program (FSAP) (see page 59). Page 49 January 2015

52 When would my insurance go into effect? Subject to the active work requirement described below, your Voluntary LTD coverage becomes effective on your date of hire as long as you submit paperwork within your first 45 days of eligibility. What is the active work requirement? Active work generally means performing with reasonable continuity the material duties of your own occupation at Syracuse University's usual place of business. You must be capable of active work on the day before the scheduled effective date of your insurance or your insurance will not become effective as scheduled. Your insurance will not become effective until the day after you complete one day of active work as a member. The active work requirement is described in further detail in the summary plan description What exclusions apply to this coverage? You are not covered for a disability caused or contributed to by any of the following: Your committing or attempting to commit an assault or felony, or your active participation in a violent disorder or riot; An intentionally self-inflicted injury, while sane; War or any act of war (declared or undeclared, and any substantial armed conflict between organized forces of a military nature); The loss of your professional or occupational license or certification; and/or A preexisting condition or the medical or surgical treatment of a preexisting condition unless on the date you become disabled, you have been continuously insured under the group policy for the 12-month exclusion period and actively at work for at least one day after the end of the exclusion period. What is a preexisting condition? A preexisting condition is a mental or physical condition, whether or not diagnosed or misdiagnosed: Which was discovered or suspected as a result of any routine or other medical examination at any time during the preexisting condition period*; or For which you have consulted a physician or other licensed medical professional, received medical treatment, services or advice, undergone diagnostic procedures including self-administered procedures, or taken prescribed drugs or medications at any time during the preexisting condition period*. What limitations apply to this coverage? LTD benefits are not payable for any period when you are: Not under the ongoing care of a physician in the appropriate specialty as determined by The Standard. Not participating in good faith in a plan, program or course of medical treatment, or vocational training or education approved by The Standard, unless your disability prevents you from participating. Page 50 January 2015

53 Able to work and earn at least 20% of your indexed pre-disability earnings, but you elect not to work; during the own occupation period, the responsibility to work is limited to work in your own occupation; thereafter, the responsibility to work includes work in any occupation. In addition, payment of LTD benefits is limited in duration: To 12 months if you reside outside the United States or Canada. To 24 months in your lifetime if your disability is caused or contributed to by mental disorders, substance abuse or other limited conditions, including but not limited to, chronic fatigue conditions, allergy or sensitivity to chemicals or the environment, chronic pain conditions, carpal tunnel or repetitive motion syndrome, temporomandibular joint disorder, or craniomandibular joint disorder. *The preexisting condition period is the three-month period just before your Voluntary LTD insurance becomes effective. Will LTD benefits end if the group policy terminates or is changed? During each period of continuous disability, The Standard will pay LTD benefits according to the terms of the group policy in effect on the date you become disabled. Your right to receive LTD benefits will not be affected by: Any amendment to the group policy that is effective after you become disabled. Termination of the group policy after you become disabled. When does my Voluntary LTD insurance coverage end? Voluntary LTD insurance ends automatically on the earliest of the following: The date the last period ends for which you make a premium contribution (except if premiums are waived while disabled); The date your employment terminates; The date the group policy terminates; The date you cease to be a member (however, insurance may continue for limited periods under certain circumstances as described in the group policy); or If applicable, the date Syracuse University ceases to participate under the group policy. Note: This policy allows for conversion privileges in certain circumstances. Page 51 January 2015

54 2015 Monthly Employee Contributions for Long Term Disability Insurance Age Cost/Hundred per Month* Under age 30 $ through 34 $ through 39 $ through 44 $ through 49 $ through 54 $ through 59 $ through 64 $ through 69 $ through 74 $ $2.70 *Contributions listed here are based on the 12-month calendar year. The actual deduction from your paycheck depends on your deduction cycle. Page 52 January 2015

55 REMITTED TUITION BENEFITS For Employees and Retirees Syracuse University offers Remitted Tuition Benefits (RTB), which may be applied to tuition charges for undergraduate and graduate courses at Syracuse University, including University College (UC), with certain restrictions. RTB may be used by you or transferred to your eligible spouse or same-sex domestic partner. Credit hours are awarded at the start of the new fiscal year and are available for use during the fall, spring or summer semesters immediately following. Please visit the Syracuse University Remitted Tuition Policy online at: for complete details. Eligibility Employees - Remitted tuition is available to all Benefits Eligible Employees. Employees using RTB receive a tuition waiver. Retirees - Remitted Tuition is available to employees who retired at age 55 or older with a minimum of five (5) consecutive years of service. Retirees using RTB receive a tuition waiver. Spouse/Same-Sex Domestic Partner Employees and retirees may transfer some or all of their available RTB to an eligible spouse or same-sex domestic partner. The value of the tuition waiver on the credit hours transferred to an eligible spouse or same-sex domestic partner will be equal to 85 percent. Credits The number of credit hours available depends upon your employment status as follows: Full-time employees receive up to 12 credit hours annually. Part-time employees receive up to 9 credit hours annually. Retirees receive up to the number of credit hours they were eligible for at the time of retirement. Getting Started Eligible employees are awarded RTB automatically upon their employment date according to the following schedule: Credits Hours Available Upon Hire Employment Date Full-Time Part-Time 7/1-9/ /1-12/ /1-3/ /1-6/ There are no forms or applications to complete to use RTB, unless the employee is transferring credits to an eligible spouse/same-sex domestic partner. Employees/retirees who wish to transfer credits to an eligible spouse or same-sex domestic partner will need to complete a Remitted Tuition Transfer Authorization Form and return it to Human Resources prior to the start of the semester in which the benefits are to be used. The form is available online at A new form will only need to be completed if you wish to make a change in the number of credits assigned, or to change the recipient, Page 53 January 2015

56 including transferring credits back to yourself. RTB credits may be used for courses offered through Syracuse University, including University College (UC), according to the following guidelines: Credit hours become available before the fall semester each year, for use during the fall, spring and summer semesters that immediately follow. Credit hours do not carry over from year to year; credits not used are forfeited. Credit hours may not be borrowed from a future year to be used in a current year. Up to six credit hours may be taken by an employee per semester or summer session. An employee may exceed six credit hours in a single semester only with the permission of his/her supervisor. An employee may take classes during regular work hours, only with the permission of his/her supervisor. Remitted Tuition applies to tuition charges only. UC registrants must pay a processing fee that is not covered by RTB. SU reserves the right to restrict the use of RTB for certain workshops, non-credit courses, and special programs. Spouses/same-sex domestic partners receiving RTB must have a United States-issued Social Security number or an individual tax identification number. Benefits Eligibility Status Change RTB will be adjusted based upon any changes in your eligibility status (e.g. moving from to part-time employment). If an employee separates from the University, the total year benefit will be pro-rated based upon his or her termination date according to the chart below and no benefits for future semesters, including Maymester or Summer Sessions will be authorized. If the employee terminates during a semester when RTB were used by the employee or spouse/same-sex domestic partner, the employee will be billed for any remaining balance after the prorated remitted tuition credits have been applied. Credit Hours Available Upon Termination Termination Date Full-Time Part-Time 7/1-9/ /1-12/ /1-3/ /1-6/ Tax Implications For information on remitted tuition taxability rules, please refer to the Comptroller's Office website at: Employees are encouraged to determine whether they are eligible to claim the federal Lifetime Learning Tax Credit to help offset their share of tuition costs paid for a participating spouse or same-sex domestic partner (if claimed as a dependent on the employee s tax return). Page 54 January 2015

57 DEPENDENT TUITION BENEFITS FOR EMPLOYEES AND RETIREES After the equivalent of three years of -time employment, Syracuse University provides educational benefits to the qualified dependents of eligible employees to assist them in pursuing their first baccalaureate degree. Benefits are limited to tuition expenses and are applicable to undergraduate coursework only. Students are eligible for only one program at a time, must meet academic and admission requirements, and be matriculated in a program of study leading to the first bachelor s degree. The following is a brief description of each Dependent Tuition Benefit Program available. Please visit the Syracuse University Dependent Tuition Policy online at: for complete details. SU Tuition Waiver Program Eligible dependents receive a tuition waiver based on your salary and your dependent s matriculation date for undergraduate study at Syracuse University. Benefits are limited to the number of credits required for his/her first baccalaureate degree. Summer Session courses are available under the Syracuse University Dependent Tuition Policy to those eligible students matriculated into Syracuse University. For those dependents who matriculate on or after Fall 2014, the value of the tuition waiver is provided in accordance with the following schedule: Qualified dependents of employees with annual salaries up to $50,000* will receive a tuition waiver. Qualified dependents of employees with annual salaries between $50,000* and $99,999* will receive a 95 percent tuition waiver. Qualified dependents of employees with annual salaries of $100,000* or above will receive a 90 percent tuition waiver. *The salary thresholds for dependent tuition benefits are measured in FY 2011 and increase in future years by the budgeted salary pro-forma. Tuition Exchange Program Eligible dependents receive tuition for -time undergraduate study at another member institution of Tuition Exchange, Inc. leading to the first baccalaureate degree. Benefits are limited to a maximum of eight semesters. Tuition is not guaranteed at any of the participating member colleges. Tuition Exchange scholarships are awarded by the participating member institutions according to their own criteria. The value and duration of each award may be restricted. Summer Session courses are not available under the Tuition Exchange program. Please visit: for more details. Page 55 January 2015

58 Cash Grant Program Eligible dependents may receive up to $1,250 per semester applied to tuition for matriculated -time studies leading to the first baccalaureate degree at an accredited institution other than Syracuse University. Benefits are limited to a maximum of eight semesters. Summer Session courses are not available under the Cash Grant program. How To Apply In addition to the following, all SU Tuition Waiver Program applicants are required to file an application for the New York State Tuition Assistance Program (TAP), within state deadlines. An exemption from this requirement is available if certain criteria are met. Consult the Dependent Tuition Policy for complete details. SU Tuition Waiver Program: Applicants must complete and submit the Dependent Tuition Application form. The form is available on the HR website at: Tuition Exchange Program: Applicants must complete the Dependent Tuition Application Form and the Tuition Exchange Request form. The form is available on the HR website at: Cash Grant Program: Applicants must complete the Dependent Tuition Application Form. The Dependent Tuition application form can be found at: New applicant applications are due no later than: Dependent Tuition Early Decision Freshman November 15 Regular Decision Freshman February 1 Tuition Exchange November 15 Cash Grant May 1 Renewal applications are due no later than: Dependent Tuition March 1 Tuition Exchange February 1 Cash Grant May 1 Page 56 January 2015

59 PAID TIME OFF FOR STAFF EMPLOYEES Holidays All staff employees are provided the following seven paid holidays each calendar year: New Year s Day, Martin Luther King Jr. Day, Memorial Day, Independence Day, Labor Day, Thanksgiving Day, and Christmas Day. Also provided are 3 paid bonus days typically assigned to aforementioned holidays that will result in long weekends. These assigned days may vary from year to year depending upon how these holidays fall. All staff employees are eligible for these holidays immediately upon employment. Floating Holidays Syracuse University provides two floating holidays available for use immediately upon employment. Floating holidays are pro-rated in the case of eligible part-time employees and must be taken within the fiscal year. Unused floating holidays cannot be carried into the next fiscal year. Vacation for Exempt (Salaried) Employees Syracuse University provides 20 days of vacation with an additional 5 days beginning in the 20 th year of employment and another 5 days in the 30 th year. Vacation time is available beginning July 1 following the date of hire. Vacation for Non-Exempt (Hourly) Employees Syracuse University provides 10 days of vacation with an additional 5 days beginning in the 5 th year of employment. Upon reaching the fiscal year in which the 11 th anniversary falls, a day for every year thereafter will accrue, up to reaching the 20 th anniversary. Upon reaching the fiscal year in which the 30 th anniversary falls, Syracuse University will provide 30 days. Vacation time is available beginning July 1 st following your date of hire. Vacation days are pro-rated in the case of eligible part-time employees. Personal Business Days for Non-Exempt (Hourly) Employees Syracuse University provides two personal business days annually beginning July 1 following the date of hire. Personal business days are pro-rated in the case of eligible part-time staff employees and must be scheduled with the approval of your supervisor. Unused personal business days cannot be carried into the next fiscal year. Sick time for Non-Exempt (Hourly) Employee - Eligible employees hired on or after the beginning of the fiscal year will accrue one day of sick pay every three months for personal or family illness, which may be taken by the end of the fiscal year. As of July 1, all active benefits eligible non-exempt staff employees are credited with six paid sick days that may be taken during the fiscal year. These six days may be used for personal illness, or to care for an ill/injured child, spouse/same-sex domestic partner, or parent. Sick days are pro-rated in the case of eligible part-time employees. Page 57 January 2015

60 LEAVE OF ABSENCE Employees may request short-term leaves of absence, with pay, for court and jury duty, military training, volunteer fire fighting, the funeral of an immediate relative (as defined in the University s Funeral/Bereavement Leave Policy), special public service assignments, or unusual personal business that cannot be accomplished outside of working hours. In addition, employees who have completed one year of continuous service are eligible to request a leave of absence, without pay, for family, health, and other personal reasons for a period of up to one year. METLIFE HOME AND AUTO INSURANCE Employees are eligible upon employment to participate in Syracuse University s Group Home and Auto Insurance Program with MetLife. Through MetLife, you can apply to purchase insurance coverage for your home, automobile, and other personal property at special group rates. After-tax payroll deduction is also available. SU s dedicated MetLife representative Tom Swanson can be contacted at HOME MORTGAGE PROGRAM The University s Real Estate Office administers a program for employees purchasing a home in the University area. The Home Mortgage Program offers a mortgage guaranteed by the University if you are purchasing a home in the University area. For more information on this program, contact the University s Real Estate Office at or visit IDENTIFICATION CARDS Employees are issued a Syracuse University identification card upon employment. The ID card enables you to obtain a discount on certain purchases at the Syracuse University Bookstore, and on the purchase of tickets for certain athletic and cultural events. It also facilitates borrowing privileges at the University Libraries and access to campus recreational facilities. Your spouse/ domestic partner and dependents may also apply for ID cards through the Office of Housing, Meal Plan and ID Card Services ( ), for which they will be charged a processing fee. ID cards enable family members to use University facilities such as the library, campus bus service, and gymnasiums. Page 58 January 2015

61 FACULTY AND STAFF ASSISTANCE PROGRAM (FSAP) FSAP offers professional and confidential counseling services. FSAP also offers other services including childcare and eldercare referral, wellness programs, adoption expense reimbursement, and mental health support. There is no cost to employees for FSAP services. Contact FSAP at or ADOPTION ASSISTANCE Syracuse University offers adoption assistance reimbursement grants to cover eligible expenses up to $5,000 for the adoption of one child, or $8,000 for simultaneous adoption of more than one child. To qualify, the child being adopted must be under 18 years of age and not biologically related to either parent. More information can be found at: humanresources.syr.edu/benefits/benefits-other/adoption-assistance/. LESBIAN, GAY, BISEXUAL AND TRANSGENDER (LGBT) RESOURCE CENTER Syracuse University values diversity in all its forms and welcomes new faculty and staff members who identify as lesbian, gay, bisexual, transgender and straight allies to our community. The University is committed to recognizing and thoughty addressing the needs of LGBT faculty and staff to help ensure a positive work experience. The LGBT Resource Center s mission is to provide safe space, advocacy, and support for lesbian, gay, bisexual and transgender, questioning/queer, and ally community. The Center sponsors activities throughout the year including a picnic on Labor Day, a luncheon in January for LGBT faculty & staff, and the Rainbow Banquet celebration in April. In addition, The Lavender Welcome Program connects LGBT faculty and staff with a returning LGBT faculty or staff member to welcome new employees to the Syracuse campus and city community. To stay informed about what is happening, join the SU Faculty & Staff Listserv and the LGBT Community Listserv by ing us at [email protected]. Policies relevant to the LGBT community can be found at: WORLDWIDE TRAVEL PROTECTION The University has contracted with International SOS (ISOS) to provide worldwide travel, medical and security assistance, and evacuation services for faculty, staff, and students traveling outside the United States on or for University business, sanctioned academic work, or research. ISOS serves to better enhance safety and to help facilitate communication in the event of emergency situations. Visit: or call Risk Management at for more information. Page 59 January 2015

62 NOTICE OF SPECIAL ENROLLMENT RIGHTS Enrollment of Eligible Employees, Spouses, Domestic Partners, and Dependents: Enrollment in benefits must take place within 31 days of an employee first becoming eligible for benefits, during an annual open enrollment period or within 31 days of an appropriate qualifying life event. All necessary forms and required documentation must be submitted to the Syracuse University Office of Human Resources within this time period. Qualifying life events for enrolling Eligible Employees, Spouses, Domestic Partners and Dependents include the following: 1. Marriage, civil union, or registered domestic partnership; or for Eligible Domestic Partners, the earliest date on which the residency and financial interdependence criteria are satisfied as defined by the Syracuse University Office of Human Resources; 2. Birth, adoption, or legal guardianship of a child; 3. Loss of benefit coverage for an Eligible Employee, Spouse, Domestic Partner or Dependent previously covered by a non-su employer or other non-su source. Coverage for an Eligible Employee, Spouse, Domestic Partner, or Dependent will be terminated upon the date he or she no longer meets the eligibility criteria for benefits (e.g., date of divorce, dissolution of marriage, civil union or registered domestic partnership, or the earliest date the Domestic Partner criteria are no longer met, as applicable). Eligible Employees must notify the Office of Human Resources and submit all necessary forms and required documentation within 31 days of the date their covered Spouse, Domestic Partner or Dependent no longer meets the eligibility criteria. Eligible Employees may voluntarily terminate coverage for themselves or their Eligible Spouses, Domestic Partners, and Dependents during an annual open enrollment period or within 31 days of an appropriate qualifying life event. For qualifying life events, benefits will be terminated as of the date of the event provided all necessary forms and required documentation are submitted to the Office of Human Resources within the 31 day time period. An Eligible Spouse's or Domestic Partner's open enrollment that includes new coverage options not previously available is considered a qualifying life event for voluntarily terminating coverage. For further information on eligibility, please refer to the Benefits Eligibility Policy online at: Page 60 January 2015

63 CONTINUATION OF HEALTH COVERAGE/COBRA This notice summarizes your rights and obligations with regard to continuation coverage under the Consolidated Omnibus Budget Reconciliation Act of 1985, as amended (commonly known as COBRA ). Please take the time to read this notice carey. In the event that you are no longer covered under a Syracuse University Group Health Plan (Group Health Plan refers to the individual medical, dental, vision, prescription drug and/or medical reimbursement plan to which you are enrolled, with eligibility determined by each individual plan), you will have the opportunity for a temporary extension of Group Health Plan coverage (called Continuation Coverage ) at active employee rates, if your coverage terminates for one of the reasons specified below. The University will notify you of your right to continue your coverage once notice has been received that an event triggering that right has occurred. If you are an employee covered by a Group Health Plan, you have the right to choose Continuation Coverage if your Group Health Plan coverage terminates due to a reduction in your hours of employment or because your employment has terminated (for reasons other than gross misconduct on your part). If you are the spouse of an employee and are covered by a Group Health Plan, you have the right to choose Continuation Coverage if your Group Health Plan coverage terminates due to one of the following events: 1. the death of your spouse; 2. the termination of your spouse s employment (for reasons other than gross misconduct) or reduction in your spouse s hours of employment; 3. a divorce or legal separation from your spouse; or 4. the entitlement of your spouse to Medicare. If you are the dependent child 1 of an employee and are covered by a Group Health Plan, you have the right to choose Continuation Coverage if your Group Health Plan coverage terminates due to one of the following events: 1. the death of a parent employed by Syracuse University; 2. the termination of a parent s employment (for reasons other than gross misconduct) or reduction in a parent s hours of employment with the University; 3. the divorce or legal separation of your parents; 4. the entitlement of a parent employed by the University to Medicare; or 5. your ineligibility for coverage as a dependent child under a Group Health Plan. Your benefit coverage may be continued for 36 months in the event of death, divorce or legal separation, entitlement to Medicare, or ineligibility for dependent coverage. Your coverage may be continued for 18 months in the event of termination or reduction in hours of employment. The 18-month coverage period may be extended to 29 months for covered family members, if: (i) any covered family member (employee, Page 61 January 2015

64 spouse, or dependent child) is determined under Title II or Title XVI of the Social Security Act to have been disabled on or within 60 days of the date of termination or reduction in hours of the covered employee s employment; and (ii) you or another qualified beneficiary notifies the University within 60 days after the determination and before the end of the 18- month coverage period. Any coverage extended after the initial 18 months because of a disability determination may be charged to you at 150% of the active employee rate (even if your coverage is ultimately continued for a total of 36 months, pursuant to the paragraph below), so long as the disabled person is covered during the extension. If it is later determined that the covered family member whose disability resulted in the extended coverage is no longer totally disabled, you or another qualified beneficiary must notify the University within 30 days of the determination. If you are a covered spouse or dependent child and you continue your coverage upon a termination or reduction in hours of employment, your Continuation Coverage may be extended to 36 months if another event (death, divorce or legal separation, Medicare entitlement, or ineligibility for dependent coverage) occurs during the initial 18-month period. If one of these events occurs, you should notify the University right away. Continuation Coverage will not last beyond 36 months from the date of the first event that made you eligible to continue your coverage. However, special rules may apply if Medicare entitlement is involved. It is your responsibility to notify the University within 60 days of the event of a divorce, legal separation, or a child losing dependent status under a Group Health Plan. Contact the HR Service Center at [email protected] or Your Continuation Coverage may be cut short for the following reasons: 1. the University no longer provides Group Health Plan coverage to any of its employees; 2. you fail to make timely payment of any premium due; 3. after you elect Continuation Coverage, you become covered under another group health benefits plan that either: (i) does not contain any exclusion or limitation; or (ii) contains an exclusion or limitation that does not apply to you or has been satisfied in accordance with federal law; 4. after you elect Continuation Coverage, you become entitled to Medicare; or 5. your Continuation Coverage has been extended for up to 29 months due to a covered family member s disability, and there has been a final determination that the family member is no longer totally disabled. If you decide to continue your coverage, you must submit a written election form to POMCO within 60 days of the later of: (i) the date on which your coverage terminates due to one of the events specified above; or (ii) the date you are given additional notice of your right to continue coverage under a Group Health Plan. If you do not return the election form within that 60-day period, it will be assumed that you do not wish to Page 62 January 2015

65 continue your Group Health Plan coverage. If you elect to continue your coverage, you will be required to pay the premium for your benefits. Except with respect to Continuation Coverage extended for up to 29 months for a disabled person and any other covered family members whose coverage is extended with the disabled person s (or up to 36 months in the event that a second qualifying event occurs with respect to a qualified beneficiary whose coverage is extended due to disability), your premium payment will not exceed 102% of the active employee rate for your benefits; this includes an administration fee. If you wish, you may pay the premium on a monthly basis. You will be required to pay the first premium payment in advance, along with any retroactive premium payments owed from the date of termination of your coverage, within 45 days after you submit your written election form. At the end of your COBRA Continuation Coverage period, you may enroll in an individual conversion health benefits contract, if a conversion benefit is provided under the applicable Group Health Plan. Marketplace Coverage In addition to COBRA Continuation Coverage, there may be other coverage options for employees/retirees and their families: When key parts of the health care law take effect, you ll be able to buy coverage through the Health Insurance Marketplace. In the Marketplace, you could be eligible for a new kind of tax credit that lowers your monthly premiums right away, and you can see what your premium, deductibles, and out-of-pocket costs will be before you make a decision to enroll. Being eligible for COBRA does not limit your eligibility for coverage for a tax credit through the Marketplace. Additionally, you may qualify for a special enrollment opportunity for another group health plan for which you are eligible (such as a spouse s/domestic partner s plan), even if the plan generally does not accept late enrollees, if you request enrollment within 30 days. Additional information about the COBRA Continuation Coverage option or applicable premium payments may be obtained from the SU HR Service Center at upon termination of coverage. All notices you submit should be addressed to the Syracuse University Office of Human Resources, Skytop Office Building, Syracuse, New York, For more information about health insurance options available through a Health Insurance Marketplace, visit healthcare.gov. 1 A dependent child includes a newborn child, an adopted child, and a child placed with the covered employee for adoption, during the COBRA coverage period. The COBRA coverage period ends at the same as the other family members. Page 63 January 2015

66 NOTICE OF PRIVACY PRACTICES THIS NOTICE DESCRIBES HOW MEDICAL INFORMATION ABOUT YOU MAY BE USED AND DISCLOSED AND HOW YOU CAN GET ACCESS TO THE INFORMATION. PLEASE REVIEW IT CAREFULLY. This Notice of Privacy Practices ("NPP") is made in compliance with the Standards for Privacy of Individually Identifiable Health Information (the "Privacy Standards") established by the United States Department of Health and Human Services ("DHHS") pursuant to the Health Insurance Portability and Accountability Act of 1996 ("HIPAA"). This NPP summarizes the privacy practices of Syracuse University's Group Health Plans. The Privacy Standards shall control in the event of a discrepancy between this NPP and the Privacy Standards. Syracuse University's Group Health Plans, which include, the Syracuse University Medical Benefits Plan; the Syracuse University Retiree Medical Benefits Plan; the Syracuse University Retiree Prescription Drug Plan; the Syracuse University Dental, Vision and Bargaining Unit Faculty Health Plan, the Syracuse University Graduate Assistant Dental and Vision Benefits Plan; and the Syracuse University Health Care Reimbursement Plan (included within the Syracuse University Cafeteria Plan and Summary Plan Description; (collectively, the "Health Plans"), are required by law to maintain the privacy of your Protected Health Information ("PHI") as defined below, and to inform you, through this NPP, about: 1. the Health Plans' duties with respect to your PHI; 2. how the Health Plans may use and disclose your PHI; 3. your privacy rights with respect to your PHI; 4. your right to file a complaint with the Health Plans and with the Secretary of DHHS; and 5. who to contact for further information about the Health Plans' privacy practices. PHI, as defined by HIPAA, includes all individually identifiable information about you that is transmitted or maintained by the Health Plans, including demographic information, and includes information that is created or received by the Health Plans that relates to: your past, present or future physical or mental health or condition; the provision of health care services to you; or the past, present, or future payment for the provision of health care to you. The Health Plans are required to abide by the terms of the NPP that is currently in effect for the Health Plans. The Health Plans reserve the right to revise or amend the terms of this NPP. Any revision or amendment will be effective for all records that the Health Plans have created or maintained in the past, and for any of your records that we may create or maintain in the future. You will be informed of any material changes made to this NPP. In addition, the Health Plans will post, at all times, a copy of its most Page 64 January 2015

67 current NPP online at You may also obtain a copy of the most current NPP at any time by calling the Syracuse University Office of Human Resources at If you have any questions about this NPP or would like further information about HIPAA, please contact Human Resources at HOW THE HEALTH PLANS MAY USE AND DISCLOSE YOUR PHI HIPAA permits the Health Plans, its Business Associates, and their agents/subcontractors, if any, to use and/or disclose your PHI, without prior authorization, for the purposes of treatment, payment, and other health care operations of the Health Plans, which are described below. Consistent with the Genetic Information Nondiscrimination Act (GINA), the Health Plans are prohibited from using or disclosing genetic information for underwriting purposes. The Health Plans will disclose your PHI to its Business Associates only if it has received satisfactory assurances that the Business Associates will appropriately safeguard your PHI. HIPAA also permits the Health Plans to use and disclose of your PHI, without prior authorization, for other specific purposes that are also described below. For each category, a description and some examples of the permitted uses and/or disclosures has been provided. The following examples are illustrative and are not meant to be a complete description of the permitted uses and disclosures of the Health Plans. A. Treatment. The Health Plans may use and/or disclose your PHI to health care providers who are involved in your care and treatment. The Health Plans may use or disclose PHI about you to physicians, nurses, paraprofessionals, technicians, or other health care providers who are involved in your care and treatment. For example, we may disclose your PHI to a physician or a pharmacy to assist in the management of your health care. B. Payment. The Health Plans may use and/or disclose your PHI to fulfill its obligation for coverage and the provision of health benefits under the Health Plans. For example, the Health Plans may use or disclose PHI to obtain or provide reimbursement for the provision of health care. Payment includes, but is not limited to, actions relating to eligibility or coverage determinations, billing, claims management, collection activities, reviews for medical necessity determinations and appropriateness of care, utilization review and pre-authorizations. C. Health Care Operations. The Health Plans may use and/or disclose PHI in order to conduct its normal business operations. For example, the Health Plans may use your PHI to conduct quality assessment and improvement activities, populationbased activities relating to improving or reducing health care costs, contacting health care providers and patients with information regarding treatment alternatives, reviewing the competence or qualifications of health care professionals, evaluating health plan performance, and other insurance related activities. Page 65 January 2015

68 D. Follow up Telephone Calls/ s. The Health Plans may call you to follow up on care or treatment you received by a health care provider, or to ask questions relating to treatment, payment, or other health care operations of the Health Plans. E. Treatment Alternatives or Other Health-Related Benefits and Services. The Health Plans may use and/or disclose PHI to tell your health care providers about or recommend possible treatment alternatives or health-related benefits or services that may be of interest to you or your health care provider. F. Individuals Involved in Your Care or Payment for Your Care. HIPAA permits the Health Plans to disclose PHI to a family member, other relative, a close personal friend, or any other person identified by you if: 1. you are present for, or otherwise available prior to the disclosure and we have either obtained your agreement to the disclosure, provided you the opportunity to object to the disclosure, or the Health Plans have reasonably inferred from the circumstances that you do not object to the disclosure; 2. due to your incapacity or an emergency circumstance the Health Plans have determined that a disclosure is in your best interest - in such circumstances, the Health Plans will only disclose PHI that is directly relevant to the person's involvement with your health care. G. As Required By Law. The Health Plans may use and/or disclose your PHI if we are required to do so under any federal, state or local law. H. Public Health Risks. The Health Plans may use and/or disclose your PHI to authorized public health officials (or a foreign government agency collaborating with such officials) so such officials may carry out public health activities. For example, The Health Plans may disclose your PHI to public health officials for the following reasons: 1. to prevent or control disease, injury or disability; 2. to report vital events such as births and deaths; 3. to report child abuse or neglect; 4. to report quality, safety or effectiveness of FDA-regulated products or activities; 5. to notify people of product recalls they may be using; 6. to notify a person who may have been exposed to a communicable disease or may be at risk for contracting or spreading a disease or condition; or 7. to your employer, in order to comply with employment laws. Page 66 January 2015

69 I. Victims of Abuse, Neglect, or Domestic Violence. The Health Plans may disclose your PHI to government authorities, including a social service or protective services agency, authorized by law to receive reports of abuse, neglect or domestic violence. For example, the Health Plans may report your PHI to government officials if it reasonably believes that you have been a victim of abuse, neglect or domestic violence. The Health Plans will make every effort to obtain your permission before releasing this information, however, in some cases the Health Plans may be required or authorized to act without your permission. J. Health Oversight Activities. The Health Plans may disclose your PHI to a health oversight agency for activities authorized by law. These agencies typically monitor the operation of the health care system, government benefits programs, and compliance with government regulatory programs. The oversight activities may include audits; civil, criminal, or administrative investigations or actions; inspections; and/or licensure or disciplinary actions. K. Lawsuits and Similar Proceedings. The Health Plans may use or disclose your PHI in response to a court or administrative order, if you are involved in a lawsuit or similar proceeding. The Health Plans may also disclose your PHI in response to a discovery request, subpoena, or other lawful process that is not accompanied by an order of a court or administrative tribunal, but only if we have first received satisfactory assurances from the party requesting the information that reasonable efforts have been made to inform you of the request, or if the Health Plans have received satisfactory assurances that efforts have been made by the party seeking the information to obtain a qualified protective order. A qualified protective order is an order of a court or an administrative tribunal or a stipulation by parties to the litigation that prohibits the parties from using or disclosing PHI for any purpose other than the litigation or proceeding. A qualified protective order will require the return of PHI to the Health Plans at the end of the litigation or proceeding. L. Law Enforcement Purposes. The Health Plans may disclose your PHI to law enforcement officials for the following reasons: Page 67 January 2015 in response to court orders, warrants, subpoenas, or summons or similar legal process; to assist law enforcement officials with identifying or locating a suspect, fugitive, material witness, or missing person; if you have been or are suspected of being a victim of a crime and you agree to the disclosure, or if we are unable to obtain your agreement because of incapacity or other emergency; if we suspect that a death resulted from criminal conduct; to report evidence of criminal conduct that occurred on our premises; in response to a medical emergency, to report a crime (including the

70 location or victims of the crime; or the identity, description or location of the person who committed the crime). M. Coroners, Medical Examiners and Funeral Directors. The Health Plans may disclose your PHI to a coroner or medical examiner for the purpose of identifying a deceased person, determining cause of death, or other duties as authorized by law. The Health Plans may also release PHI to funeral directors as necessary to carry out their duties. N. Organ, Eye, or Tissue Donation Purposes. The Health Plans may use or disclose your PHI to organ procurement organizations or other entities engaged in the procurement, banking, or transplantation of organs, eyes, or ties for the purpose of facilitating donation and transplantation. O. Research. In most cases, the Health Plans will ask for your written authorization before using and/or disclosing your PHI to conduct research. However, in limited circumstances we may use and/or disclose PHI without authorization if: (i) the use or disclosure was approved by an Institutional Review Board or a Privacy Board; and (ii) we obtain representations from the researcher that the information is necessary for the research protocol, PHI will not be removed from our location, and the information will be used solely for research purposes; or (iii) the PHI sought by the researcher relates only to decedents and the researcher agrees that the use or disclosure is necessary for the research. P. Uses that Require Your Written Authorization. Any use or disclosure of any PHI for marketing purposes and disclosures that constitute the sale of PHI require your written authorization; Psychotherapy notes will only be used and disclosed with your written authorization; Any other uses and disclosures not specified in this Notice require your written authorization. Q. To Avert Serious Threat to Health or Safety. The Health Plans may use or disclose your PHI when necessary to prevent or lessen a serious and imminent threat to your health or safety, or the health or safety of another person or the public. In such cases, the Health Plans will only share your PHI with a person or persons reasonably able to prevent or lessen the threat, including the target of the threat; or if it is necessary for law enforcement authorities to identify or apprehend an individual. R. Specialized Government Functions. The Health Plans may use and disclose PHI regarding: Military and veteran activities; Intelligence, counter-intelligence, and other national security activities Page 68 January 2015

71 authorized by law; Protective services for the President, to foreign heads of state, or to other persons authorized by law; Inmates to a correctional institution or a law enforcement official having lawful custody of an inmate or other individual. S. Workers' Compensation. The Health Plans may disclose your PHI for workers' compensation or other similar programs that provide benefits for work-related injuries or illnesses. Except as otherwise indicated in this NPP, uses and disclosures for all other purposes will be made only with your written authorization. You may revoke an authorization at any time, provided that your revocation is done in writing, and except to the extent that the Health Plans have already relied upon your authorization. YOUR RIGHTS REGARDING YOUR PHI HIPAA provides you with the following rights regarding the PHI we maintain about you: A. Right to Inspect and Copy. You have the right to inspect and receive a copy of your PHI contained in a "designated record set" for as long as the Health Plan maintains the PHI in the designated record set, except for psychotherapy notes; information compiled in reasonable anticipation of, or for use in, a civil, criminal, or administrative action or proceeding; and PHI maintained by the Health Plans that is subject to the Clinical Laboratory Improvements Amendments of If your PHI is in an electronic file, you may request an electronic copy of the record. A "designated record set" is a group of records maintained by or for a health plan that is the enrollment, payment, claims adjudication, and case or medical management record systems maintained by or for a health plan; or use in whole or in part, by or for the health plan to make decisions about individuals. To inspect or obtain a copy of your PHI contained in a designated record set, please submit a request in writing to the Office of Human Resources at Syracuse University, Skytop Office Building, Syracuse, New York If you request a copy of your record set, we may charge a fee for the costs of copying, mailing or other supplies we use to fulfill your request. The standard fee is $0.75 per page and must generally be paid before or at the time we provide you with copies of your PHI. The Health Plans will respond to your request for inspection of records within 10 days, and will respond to requests for copies within 30 days if the information is located within our facility and within 60 days if the information is located off-site at another facility. If the Health Plans needs additional time to respond to your request for copies, we will notify you in writing within the time frame above to explain the reason(s) for such delay and when you can expect to have a final Page 69 January 2015

72 answer to your request. Under certain circumstances, the Health Plans may deny your request to inspect or obtain a copy of your PHI. If your request for inspection is denied, we will provide you with a written notice explaining our reasons for such denial, and will include a complete description of your rights to have the decision reviewed and how you can exercise those rights. B. Right to Amend. You have the right to request that the Health Plans amend your PHI or a record about you in a designated record set for as long as the information is kept by the Health Plans, if you feel that the PHI the Health Plans have about you is incorrect or incomplete. The Health Plans may deny your request for amendment if it determines that the PHI or record that is the subject of the request: was not created by the Health Plans, unless you provide a reasonable basis to believe that the originator of the PHI is no longer available to act on the requested amendment; is not part of the designated record set; would not be available for your inspection under the Privacy Standards (as described in Right to Inspect and Copy Section, above); or is accurate and complete. To request an amendment, your request must be made in writing and submitted to the Office of Human Resources at Syracuse University, Skytop Office Building, Syracuse, New York In addition, your request should include the reasons(s) why you believe the Health Plans should amend your PHI. The Health Plans will respond to your request for amendment no later than 60 days after the receipt of your request. If the Health Plans need additional time to respond to your request, we will notify you in writing within 60 days to explain the reason(s) for the delay and the date by which it will complete your request. If the Health Plans deny your request for an amendment it will provide you with a written notice of the denial that explains the reasons for doing so. You will have the right to submit a written statement disagreeing with the denial. You will also be informed of how to file a complaint with the Health Plans or with the Secretary of the DHHS. These procedures will be explained in greater detail in any written denial notice. C. Right to an Accounting of Disclosures. You have the right to request an "accounting of disclosures." An "accounting of disclosures" is a list of disclosures the Health Plans have made regarding your PHI. An accounting of disclosures will include all disclosures except the following: Disclosures to carry out treatment, payment, and health care operations; Page 70 January 2015

73 Disclosures made to you; Disclosures made pursuant to your authorization; Disclosures made in a facility directory or to persons involved in your care; Disclosures for national security or intelligence purposes; Disclosures to correctional institutions or law enforcement officials; or Disclosures made before April 14, The accounting of disclosures will be in a format that is consistent with the requirements of the Privacy Standards. To request an accounting of disclosures, you must submit your request in writing to the Office of Human Resources at Syracuse University, Skytop Office Building, Syracuse, New York Your request must include a time period of requested disclosures, which may not be longer than six years and may not include dates before April 14, The first list you request within a 12-month period will be free. Additional lists within the same 12 month period will be assessed a charge for the costs of providing the list. The Health Plans will notify you of the cost involved, at which time you may choose to withdraw or modify your request before any costs are incurred. The Health Plans will respond to your request for an accounting of disclosures within 60 days from the receipt of such request. If the Health Plans need additional time to prepare the accounting, they will notify you in writing within 60 days about the reason for the delay and provide you with the date when you can expect to receive the accounting. D. Right to Receive Notifications of Breaches. You have the right to receive notifications of breaches of your unsecured PHI. You need not specifically request such notification; it will be provided to the extent required by the privacy rules. E. Right to Request Restrictions. You have the right to request a restriction or limitation on the PHI the Health Plans use or disclose about you for treatment, payment or health care operations. You also have the right to request a limit on the medical information that the Health Plans disclose about you to someone who is involved in your care, like a family member, relative, friend, or other person(s) identified by you. The Health Plans are not required to agree to your request for restriction. If the Health Plans do agree to a requested restriction, the Health Plans may not use or disclose PHI in violation of such restriction, unless the information is needed to provide you with emergency care or treatment, or as otherwise required by law. Under certain circumstances, the Health Plans may terminate its agreement to a restriction. To request restrictions, you must make your request in writing to the Office of Human Resources at Syracuse University, Skytop Office Building, Syracuse, New York In your request, you must tell us (1) what information Page 71 January 2015

74 you want to limit; (2) whether you want to limit our use, disclosure or both; and (3) to whom you want the limits to apply, for example, disclosures to your spouse. F. Right to Request Confidential Communications. You have the right to request that the Health Plans communicate with you about you and your PHI in a certain way or at a certain location. For example, you can ask that the Health Plans contact you only at work or by mail. The Health Plans will not ask you the reason for your request, and will accommodate all reasonable requests. Your request must specify how or where you wish to be contacted, and how payment for your health care will be handled if we communicate with you through this alternative method or location. To request confidential communications, you must make your request in writing to the Office of Human Resources at Syracuse University, Skytop Office Building, Syracuse, New York G. Right to Receive a Paper Copy of This NPP. You have the right to receive a paper copy of this NPP at any time. Even if you have agreed to receive this NPP electronically, you are still entitled to a paper copy of this NPP. To obtain a paper copy of this NPP please contact the Office of Human Resources at Syracuse University at COMPLAINTS If you believe your privacy rights have been violated, you may file a complaint with the Privacy Official at the Office of Human Resources at Syracuse University, with Syracuse University's Privacy Officer, and/or with the Secretary of the DHHS. To file a complaint with the Privacy Official at the Office of Human Resources at Syracuse University, please submit a written complaint to Privacy Official, Office of Human Resources at Syracuse University, Skytop Office Building, Syracuse, New York To file a complaint with Syracuse University's Privacy Officer, please submit a written complaint to Privacy Officer, Office of Risk Management, Skytop Office Building, Syracuse, New York The Health Plans will not retaliate against you for filing a complaint with a Privacy Official of Syracuse University, or with Secretary of the DHHS. CONTACT PERSON If you have any questions about this Notice of Privacy Practices or subjects addressed in it, please contact: Privacy Official, Office of Human Resources at Syracuse University Skytop Office Building Syracuse, New York , Page 72 January 2015

75 Notice Regarding the Women s Health and Cancer Rights Act of 1998 Federal law requires group health plans that provide medical and surgical benefits for mastectomies to provide coverage in connection with the mastectomy (in the manner determined by the attending physician and the patient) for: reconstruction of the breast on which the mastectomy was performed, surgery and reconstruction of the other breast to produce a symmetrical appearance, prostheses, and treatment of physical complications at all stages of mastectomy, including lymphedema. Group health plans and health insurers may not deny eligibility to enroll, renew, or continue group health plan coverage to avoid providing coverage for breast reconstruction or mastectomy complications. In addition, the law prohibits penalizing or otherwise reducing or limiting the reimbursement of an attending provider for the required care, or providing any incentive (monetary or otherwise) to induce the attending provider to provide care that would be inconsistent with the law. Please refer to the benefit information that has been provided to you on page 9 for the coverage that you have selected, for the amount of any deductible or limitation that may apply. If you have any questions about this coverage, please contact your Plan Administrator (SU Human Resources at ) or the health plan administrator (POMCO at ). Summary of Benefits and Coverage (SBC) Choosing health coverage is an important decision. To help you make an informed choice, SU and other employers make available a Summary of Benefits and Coverage (SBC). The SBC summarizes important information about health coverage in a standard format to help you compare features across coverage options available to you. The University s SBCs are posted on the Human Resources website at under Helpful Links/ Plan Designs. A paper copy of the SBC is available, and may be requested at any time free of charge by contacting HR at Page 73 January 2015

76 Information Security PROTECTING UNIVERSITY INFORMATION: IT S UP TO YOU Syracuse University employees are exposed to all kinds of information in many different formats such as student and employee personal records, financial and payroll information, Social Security numbers, SUID numbers, and research data, to name a few. It is critical that all SU faculty and staff understand how to protect University information when they access or share this information using any kind of device including desktop or laptop computers, hand-held devices, smart phones, and thumb drives while working in their office, at home, across the country, or across the globe. The University s greatest defense against unauthorized or unlawful disclosure of confidential information comes from alert, informed faculty and staff members who understand and follow good security practices. Critical Information: A Case for Extra Protection Many different kinds of information are transmitted and shared across the University every day. Some types of information are extremely confidential and employees must take added measures to protect this information. The state and federal government have special regulations for maintaining confidentiality of some kinds of information, including the following: Information covered by the Federal Educational Rights and Privacy Act (FERPA). Most student information is covered under FERPA regulations. Certain personally identifiable information (PII), including Social Security, credit card, and bank account numbers, are covered by state disclosure laws. Disclosure of such information to unauthorized parties is forbidden. Examples of University information that may not be covered under state or federal regulations, but which also requires extra layers of protection, include the following: Employee personal information, including but not limited to, performance reviews, disciplinary actions, and salary information. University budget and financial information, grants and endowment information, donor information, and contract information. A list of Sensitive and Confidential information can be found at: Rule of thumb for assessing the sensitivity of information: What would happen if the information you use as part of your job requirements was stolen, posted on a public web site, or appeared on the evening news? Page 74 January 2015

77 Accessing University Information NetID and password: The first layer of defense Access to the systems that contain University information is often controlled through the NetID and password. It is essential that all SU employees protect their NetID and password by maintaining good password practices: Don t share your password with anyone. Create a strong password by following the recommendations on the Information Technology and Services (ITS) security web site. Change your password once a year or if you suspect it may be known to someone else. Don t use your NetID password for any non-su service, such as online banking or online shopping services. Never use your NetID and password to log onto open Internet services at web cafes or other public machines or wireless hotspots. These devices and networks are extremely insecure. More information about password practices can be found online at: its.syr.edu/security/passwords. Protecting your work station: The second layer of defense It is critical that SU employee workstations be kept as secure as possible. Departmental computing support personnel are responsible for ensuring all University-owned computers are equipped with the University s recommended antivirus software and are updated with the latest operating system security patches, and for maintaining other security measures to prevent the computer from being compromised. Employees are also responsible for ensuring their computer devices are secure by doing the following: Never download recreational software such as P2P file sharing programs, desktop gadgets, or other free downloads from the Internet to any computing device you use for work-related activities. These programs often include viruses, worms, Trojans, or other malware that compromise the security of your device and the confidential information you access with the device. Always log out of information systems when you leave your workstation, including , MySlice applications, MyReports, and Blackboard. Use a locking screen saver when you are away from your workstation. Lock your office door when you are away from your desk. Never leave a portable computing device unattended. Lock up all removable media. Web browsers are frequently targeted by hackers. Use caution when surfing web sites. Never allow your web browser to automatically install something Page 75 January 2015

78 from a web site. Beware of pop-ups and requests to install ActiveX on your computer. Remote Access to University Information The safest place for University information is on secure servers located on the University campus. However, many SU employees need to access University information from home or while away from campus for business reasons. It is critical that employees maintain the security of this information even when they are not on campus. SU provides specific tools and methods to allow secure access to University information and systems from remote locations. Details about how to gain remote access are available on the ITS security web site at: its.syr.edu/security/remoteaccess/index.cfm. Security tools: Ways to protect information you access when off campus: Virtual Private Network (VPN): Syracuse University's Virtual Private Network (VPN) service enables students, faculty, and staff to access online University information, resources and services from off-campus locations in the most secure manner possible. VPN builds an encrypted, virtual tunnel from a client's computing device to the University's network and, by doing so, protects the privacy of the data that is exchanged over the Internet between the device and the SU network. The University s VPN system provides a secure network path between your remote computing device and the University s network, which helps protect the information exchanged across the Internet from eavesdroppers. Further information about the University s VPN service can be found online at: its.syr.edu/security. Remote Desktop: This tool enables employees to access data stored on their office computer from off-campus locations. It operates as if you were sitting at your office computer, so the data stays on campus when used in combination with the VPN service and meeting the requirements outlined in Remote Access Authorization Process. Department DSP s need to open this option through Active Directory. This tool gives employees access to important information from offcampus locations, while maintaining the security of that information. Terminal Server: This is a secure server used to store information that employees can access from off-campus locations after logging in with their NetID and password. The information that is stored on these servers cannot be downloaded onto insecure computing devices, such as laptop computers or thumb drives. Some University departments store confidential data on a secure server, which employees can access via their NetID and password from on- or off-campus. These terminal servers work much like a remote desktop connection to your office computer, but are used by more than one person. Information stored on these servers cannot be downloaded onto insecure computing devices, such as laptop computers or thumb drives. Page 76 January 2015

79 Transmitting and Sharing University Information It is sometimes necessary for University employees to share or transmit information to colleagues or outside vendors. Requests for vendor access should be made by sending a request to [email protected]. Share University information only with authorized individuals who require access as part of their University role, or with external parties who have been approved by the owner of the information or by your department or unit. Use only those methods recommended by your departmental computing support person for sharing confidential information. Never copy confidential information onto an unsecured personal laptop computer, home computer, thumb drive, CD, or other removable media device. All enterprise and confidential data which the employee uses must remain within campus boundaries (on campus servers). Any exceptions to this rule must be approved by the DSP and device encryption installed. About Confidential information is frequently transmitted via . Faculty and staff must be extremely cautious when using for this purpose. In many cases, traffic flows over insecure networks, particularly when senders are communicating with someone outside of the University s system. Therefore, sensitive information should not be sent via unless the sender and receiver use the same campus system (e.g. Information can be safely shared if both parties use the University s Outlook/Exchange system or if both parties use GroupWise). When in doubt, ask your local computing support person or [email protected]. Instant messaging, chat programs: These kinds of commercial communications systems send information through external servers that are not part of the SU network infrastructure and are not controlled by SU. In many cases, the information is not protected while it travels over the Internet. Therefore, never use these methods for exchanging sensitive/confidential information. The Final Key: Foiling Hackers and Thieves SU employees are the key to protecting the University s information resources. Here are some simple things you can do to help keep SU information resources out of the hands of hackers and thieves. pitfalls: Always be wary of unsolicited s. Do not open attachments unless you are expecting an attachment from a friend or colleague. Never click on links embedded in unsolicited s. Beware of phishing scams and other Internet hoaxes that attempt to trick you into revealing your personal information such as bank account, credit card, Social Security numbers, or account passwords. Page 77 January 2015

80 Phone calls: Always be wary of unsolicited phone calls from people looking for any kind of employee or student information or access to accounts. Information-security shortcuts: Always be wary when someone asks you to violate common, information-security practices or take security shortcuts. When in doubt: Call your supervisor; call the ITS Help Desk at ; or Get Informed, Get Involved More information about SU security policies, procedures, and safe computing is available on the ITS Security website at: its.syr.edu/security. Page 78 January 2015

81 WORKLIFE AT SU Welcome to SU! As a new employee you are probably just getting used to our campus, your job and your new work environment. We know that for you to do your best at work, you need solutions to the career and life challenges that will impact your ability to balance your work and home life. For that reason, we d like to introduce you to our WorkLife program, and its host of support services and people who can assist you throughout your journey at the University. Our services are designed to support you every step of the way! SU s Recreation Services offers numerous workout facilities with modern equipment, workout classes, and personal fitness and nutritional counseling for employees. Access to these facilities is also available to your family. The University offers many programs, services, and events to promote wellness among our employees. Our Faculty and Staff Assistance Program (FSAP) provides free confidential counseling services for you and your family to address such challenging issues as anxiety, depression, grief, substance abuse, work stress, marital and family concerns and other life transitions. Concerns about quality and affordable child care and elder care are a source of stress for many employees. SU is committed to providing support and offers services such as: elder care and child care referrals; on-site child care; long-term care insurance; pre-tax reimbursement for dependent care expenses; and an adoption expense reimbursement program. Please see our FSAP web site at fsap.syr.edu for further information. Our flexible work policy not only supports the University s sustainability objectives, it supports employees looking to balance their work/life by adopting an alternative work schedule. The flexible work policy provides guidelines for supervisors and eligible staff with a variety of flexible work arrangements, including telecommuting, flex-hours, shared work, and a compressed work week. The Office of Human Resources is here to support supervisors and staff through the process. For more information please visit our flexible work website at or the Organizational Development office at x2488. Please visit our web site at Page 79 January 2015

82 POMCO (medical, COBRA) SUBlue SUOrange SUPro BENEFIT PROVIDERS CONTACT INFORMATION Provider/Plan Contact information Claim information 2425 James Street; Client #770 Syracuse, NY GO1-SU44 ( ) Express Scripts (Medco) (Prescription Drugs) 100 Parsons Pond Drive Franklin Lakes, NJ WageWorks PO Box Lexington, KY Delta Dental One Delta Drive Mechanicsburg, PA VSP Vision One Gatehall Drive - 3rd Floor Parsippany, NJ SEBF Dental & Vision 1153 West Fayette Street, Suite 302 PO Box 1600 Syracuse, NY MetLife Auto/Home Local Representative Tom Swanson: The Standard (Long Term Disability) TIAA- CREF/Retirement Planning South Clinton Street, Suite 310 Syracuse, New York Online access code to change elections: Noncontributory Retirement Plan: SURETP Voluntary Retirement Plan: SUTDAP Contract # 000SURX Carrier Number 3949 Group # 2310 Page 80 January 2015

83 UNIVERSITY CONTACT INFORMATION Syracuse University Human Resources Employment.. x4042 Faculty and Staff Assistance Program (FSAP). x1087 Organizational Development & Training. x2488 Service Center/Benefits. x4042 Sexual Harassment x1520 Student Employment Services Steele Hall x2268 Other Syracuse University Departments Bookstores: Schine x9900 Mount Olympus x9935 Lawrinson.. x9939 Hazard Communication Training.. x5107 ID Card Services.. x2726 Information Technology and Services.. x2677 Parking.. x4652 Payroll... x4042 Public Safety (Communications Center)... x2224 Recreational Services. x4967 University College (Continuing Education). x9378 Internet Services Information Technology and Services Page 81 January 2015