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The College offers group membership, through Excellus BCBS, with three health insurance plan options.
You have 30 days from your date of hire to enroll in your medical benefits.
Active Employee Medical Information
All benefit summaries can be found online at aleraedge.com.
PPO-L: Co-pays $30 PCP/Specialist; no co-insurance; no-deductibles; free access to Telemedicine
HealthyBlue: Hybrid plan; co-pays $25 PCP/$40 Specialist; co-insurance and deductibles; ThriveWell program to track your health habits, get points and earn up to $500 a year!; free access to Telemedicine
SimplyBlue: High deductible health plan (HDHP); preventive services covered in full; all other services are at full expense of individual. Health Savings Account (HSA) helps with out-of-pocket expenses
Benefit Summaries
Coverage Tiers:
- Individual
- Employee/spouse
- Employee/child(ren)
- 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.
Telemedicine
*Access to TELEMEDICINE (www.excellusbcbs.com/telemedicine), 24/7 Nurse Call Line (1-800-348-9786) and Blue365 (www.blue365deals.com) for deals and discounts on healthy lifestyle products and services
Dental Coverage with Excellus BCBS
The college provides dental coverage to full-time employees for a minimal monthly fee.
Dental Blue Summary 2024
Find a Dentist
Go to Excellus BCBS Find a Dentist webpage - https://www.excellusbcbs.com/wps/portal/xl/dtp/dentist
Step 1: Select Your Health Plan: “Dental Blue Options”
Step 2: Narrow Your Search: Enter your current dentist’s information or search your zip code.
Vision Service Plan (VSP) Highlights:
Guardian's affiliation with Vision Service Plan (VSP) offers one of the largest vision care network in the industry with over 70,000 provider access points nationwide.
Find a Provider: Go to https://www.vsp.com/eye-doctor or call VSP at 800-877-7195
Guardian Vision Plan Highlights:
Guardian's affiliation with Davis Vision offers access to over 93,000 provider access points nationwide, including private practice providers and many convenient retailers such as Costco, Walmart, Sam's Club, Target, Visionworks, Visionworks Online and contracted Pearle locations.
Find a Provider: Go to www.guardiananytime.com or call Davis at 877-393-7363
Davis Vision PPO vs VSP Vision Comparison
Additional information including enrollment tiers and cost is available on the benefits portal www.enrollingiseasy.com.
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Employees enrolled in the SimplyBlue High Deductible Health Plan are eligible to contribute to the Health Savings Account (HSA). As the high deductible health plan only covers the cost of preventive services, an HSA can be used to cover any additional medical expenses. The funds contributed to the HSA are withheld pre-tax.
If you contribute at least $5 per pay to your HSA, Le Moyne will contribute a starting balance of $300 plus an additional $15 per pay. You will only receive the Le Moyne contribution if you contribute at least $5 per pay.
The 2024 IRS maximum contribution:
· Individual plans: $4,150
· Family plans: $8,300
· Catch-up amount: $1,000 – for employees age 55 or more
Flexible Spending Accounts allow you to save taxes on the money you spend for uncovered medical/dental and/or dependent care expenses. You can set aside money through payroll deductions during the calendar year to pay for predictable expenses, and amounts are deducted from your gross pay before federal, state and Social Security taxes are withheld. Because you pay no taxes on your FSA deposits, you effectively increase your spendable income over the year.
Plan Highlights
- The Healthcare Account is used to pay for any medical and dental expenses that are not covered by insurance plans. Some of the expenses eligible for reimbursement are: deductibles and co-payments under health insurance and dental plans; orthodontic care; chiropractic care; eyeglasses and contact lenses, etc. Review list of FSA eligible expenses and the FSA store flyer. The maximum contribution is $3,200.
- Carry-over Rule: If you have a balance remaining at the end of the calendar year, this will automatically carry over to the next calendar year, up to the maximum carryover amount set by the IRS. This "carry-over" amount will not effect the maximum you can contribute. For PY 2023, the maximum carryover is $610 (to be added to your 2024 balance). For PY 2024, the maximum carryover is $640 (to be added to your 2025 balance).
- The Dependent Care Account is used to pay for certain dependent care expenses incurred because you (and your spouse, if married) are employed. Eligible expenses include charges for the care of dependent children age 12 and under or for elderly or disabled family members who are dependent on you for financial support. The maximum annual contribution is $5,000 and may be less under certain circumstances (e.g., the limit is $2,500 if you are married filing separately). There is no carry-over rule for the dependent care account.
Enrollment: During Open Enrollment each fall, you decide the total amount you want deposited into either or both of the FSA accounts for the next calendar year. That amount is deducted from your paychecks in equal increments throughout the year.
Please note: Once you choose your FSA deposit amount, you may not change or stop your deductions during the year unless your family status changes (due to marriage or birth of a child, for example), and the action must be consistent with the status change.
Your Account
Register and view your AleraPay account:
AleraPay Consumer Portal Guide|
AleraPay Enrollment Kit
How to Submit Claims
AleraPay Claim Form
Direct Deposit Set up
AleraPay App
You have a 120-day period following the end of year of your Plan Year to file for reimbursement of expenses incurred in the previous Plan Year.
FSA Relief
OptumRx - Pharmacy Benefit Manager
Member Services: 877-797-4877
Member Portal: www.OptumRx.com
OptumRx Premium Formulary Exclusions
Premium Formulary: www.optumrx.com/CTRSS
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.
Additional information:
Home Delivery
OptumRx Digital
OptumRx Specialty Copay Card
Generic Medications
Thrive Well (HealthyBlue plan) Thrive Well Flyer
With our Thrive Well program, you can earn rewards up to $500 per person* for completing a health risk assessment, participating in healthy missions and challenges, and other activities like going out for a run, working around the yard, and even taking the stairs.
ThriveWell will be available to employees through the Virgin Pulse mobile app and web browser.
Rewards are a combination of a points and levels game structure with the addition of specific action rewards. This setup allows employees to focus on a few specific actions to earn a reward and will also give them a game experience of working through levels. Employees will start by registering and setting up their online account for points. As they complete healthy activities such as step tracking, Journeys, and Daily Cards, they’ll move through levels and continue earning points. When they reach milestone levels, they’ll unlock Pulse Cash rewards that they can redeem for gift cards and merchandise
*Log into your member account to confirm coverage. Reward amounts may vary by contract.
Health Insurance & Social Security
Employees who continue working beyond the 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 Office three 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.
To help with important insurance decisions the below representatives can assist you with all of your Medicare questions and options:
Eric Lintala, CHC, Executive Benefit Consultant
AleraGroup
W: 1-800-836-0026, x7320
C: 585-704-3009
E: [email protected]
Myrna Koldin, Aging Services Specialist
Onondaga County Department of Adult & Long Term Care Services
421 Montgomery St. - 10th Floor
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 make the election within 60 days of receiving the COBRA notice.