The College offers group membership, through Excellus BCBS, with three health insurance plan options.
Eligibility: New full-time employees may enroll in the medical plan of their choice within 30 days of their hire date and coverage is effective the first of the month following their date of hire. If a plan is not selected within the 30 day period, enrollment will only be permitted during the annual open enrollment period. Enrollment or changes in plan may take place during open enrollment or due to a qualifying event (i.e. spouse's loss of coverage, birth/adoption, marriage/divorce, etc). The Office of Human Resources must be notified within 30 days of the qualifying event in order to allow the change.
Coverage Tiers: Employees may select individual, employee/spouse, employee/child(ren), or family coverage.
Both employees and Le Moyne College contribute toward the cost of the health coverage. Employee health and dental premium deductions are taxed prior to federal, state and FICA tax calculations.
Active Employee Medical Information 2018
OptumRx - Pharmacy Benefit Manager
Member Services: 877-797-4877
Premium Formulary: www.optumrx.com/CTRSS (Drug pricing based on the benefit plan design will be available 1/1/2017)
OptumRx is our pharmacy benefit manager for all PPO and HealthyBlue participants. High deductible (Simply Blue) plan participants will remain with Excellus for prescription services. The current member copays will remain the same and the availability of mail-order service will continue.
As a reminder, with OptumRx, employees that participate in the PPO-L or HealthyBlue medical plan receive a separate pharmacy ID card to use when filling prescriptions.
Every year, and with any change in vendors, changes are made to the prescription formulary which determines the member’s copay and any therapy protocols (i.e. prior authorization or step-therapy for specific medications). The LMC Transitioning to OptumRx.pdf includes detailed information including a formulary list of frequently utilized medications.
Excellus BCBS Release.pdf
HSA-Custodial Agreement and Disclosure.pdf
SimplyBlue Plan Information with Health Savings Account (HSA)
HealthyBlue HealthyRewards Brochure - HR-Brochure.pdf
HealthyBlue HealthyRewards Reference Guide - HR-RefGuide.pdf
Group Health Insurance Summary Plan
Summary of Material Modifications
Health Insurance & Social Security
Employees who continue working beyond teh age of eligibility for full social security retirement are entitled to the same medical coverage they had before that age. However, employees and their spouses should contact the Social Security Officethree months prior to their eligibility age in order to enroll in Part A of the Medicare Program and to obtain current and specific information about the entire program. Employees do not need to sign up for Part B of Medicare as long as they are active employee covered under the Le Moyne College medical plan.
Under the provisions of a law commonly referred to as COBRA (Consolidated Omnibus Budget Reconciliation Act), a terminating employee may usually arrange to continue coverage for a longer period, if necessary, but the employee is responsible for paying the full cost. Arrangements for continuation of coverage are made through the Office of Human Resources.
Also, under the COBRA law a participant who becomes ineligible for coverage due to a loss of dependent status (a divorced spouse or child aging out) can continue coverage for a limited period, but the participant must notify the Office of Human Resources within 30 days of the qualifying event.
2018 LMC COBRA Health Dental Vision Rates.pdf