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About Your Health Insurance Benefits

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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 30 days of the qualifying event.

Dental Coverage with Excellus BCBS

The college provides dental coverage to full-time employees for a minimal monthly fee. 

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.

Dolphins Live Well

Mission: In alignment with our Ignatian identity, Dolphins Live Well promotes integrated wellness of mind, body, and spirit, by empowering the Le Moyne community to make active decisions regarding their overall wellbeing through insight, inquiry, and involvement.

Le Moyne College cares for the health and well-being of its faculty, staff, and students - that’s why we’ve developed Dolphins Live Well. When you make smart, well-informed health care decisions, you reduce your out-of-pocket health care costs and increase your odds of living a long, healthy life.

Our VISION is to be/provide a comprehensive source of resources and information serving a vibrant campus community where personal development and wellbeing is the norm.

  • Recreation Center and fitness classes
  • Free flu shot clinics in the fall
  • Go Move Challenge in February: Every minute of movement counts in the Go Move Challenge as faculty and staff compete to determine which Jesuit university is the most active. Movement is defined as any intentional exercise that causes at least a small increase in breathing or heart rate. 

Wellness is...

  • an active, intentional, lifelong process of becoming aware of choices and making decisions toward a balanced and meaningful life.
  • a way of life oriented toward optimal health and well-being in which body, mind, and spirit are integrated by the individual to live more fully within the human and natural community. - Myers, Sweeney, Whitmer
  • an active process through which people become aware of, and make choices toward, a more successful existence. - Hettler
  • Giving good care to your physical self, using your mind constructively, expressing your emotions effectively, being creatively involved with those around you, and being concerned about your physical, psychological, and spiritual environments. - Travis

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

  1. 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.  The IRS has indicated that expenses for solely cosmetic reasons or for the maintenance of general health are not eligible expenses for medical care.  Premiums you pay for medical and dental coverage, whether for yourself, your spouse, or a dependent, are not eligible expenses. Review list of FSA eligible expenses and the FSA store flyer.  The maximum contribution is $2750. 
    • $550 Carry-over Rule: If you have a balance remaining at the end of the calendar year, up to $500 will automatically carry over to the next calendar year.  This "carry-over" amount will not effect the maximum you can contribute.
  2. 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 $5000 and may be less under certain circumstances (e.g., the limit is $2500 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

Reimbursements:

AleraPay will receive medical and dental claims directly from an Excellus provider and pay you directly out of your Flexible Spending Account for those expenses.  You will receive a check or if you would like to set up direct deposit (see the form below).  AleraPay debit cards to be used at the pharmacy for your prescriptions and for vision expenses.  These cards will be loaded with your FSA funds. Any prescription not paid with the debit card will require a paper claim submission to AleraPay in order to receive reimbursement. 

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. 

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You cannot switch funds between accounts.

If you terminate employment or go on an unpaid leave of absence, your deductions will stop and you may not submit claims for services incurred after your termination date or LOA start date. When you return from an unpaid leave of absence, you may resume deductions for the rest of the plan year.

IMPORTANT: Once the period for submitting claims expires, any funds remaining in your accounts must be forfeited, in accordance with Internal Revenue Service regulations. This is called the "use it or lose it" rule. Therefore, it is important to estimate your expenses carefully when you enroll in the plan.

Summary Plan Description (FSA).pdf
FSA Relief

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: eric.lintala@aleragroup.com

 

Myrna Koldin, Aging Services Specialist
Onondaga County Department of Adult & Long Term Care Services
421 Montgomery St. - 10th Floor

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: 

  • 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.

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; HealthyRewards 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

Blue PPO-L
Healthy Blue Hybrid
Simply Blue HDHP
HealthyBlue HealthyRewards Brochure - HR-Brochure.pdf
HealthyBlue HealthyRewards Reference Guide - HR-RefGuide.pdf

 

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

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

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.​