Reduced Medical Rates: Schedule B

Benefits-eligible employees enrolled in the Syracuse University health plan automatically pay the Schedule A rates.  Depending on your household income and size (see the chart below), you may be eligible for lower health plan contributions under Schedule B. You must apply and qualify for reduced rates. Certain employees represented by the SEIU collective bargaining agreement are automatically enrolled in the Schedule B rates.

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Eligibility for this program is based on household income and household size.

For 2022, the criteria is as follows:

Household SizeHousehold Income
1Less than $39,000
2Less than $52,000
3Less than $66,000
4 and upLess than $80,000

Household size is the number of individuals declared on your Federal Income Tax Return, 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 who are either under age 19 and living with you, or age 19 or older and enrolled as your dependent in the medical plan.

Household income is the combined adjusted gross income disclosed on your Federal Income Tax Return, including for your spouse or domestic partner and your children age 19 or older, if they are enrolled on your medical plan. The adjusted gross income is on the Federal Income Tax Return (line 8b of Form 1040).

Application Process

If you are a new employee, applications and Federal Income Tax Returns must be received within 31 days of your hire date.  For existing employees, the deadline to submit the application for reduced rates for 2022 was Dec. 3, 2021.

  1. Complete the 2022 Syracuse University Application for Schedule B Medical Contributions [PDF] (to receive benefits in calendar year 2022).
  2. Submit the completed application, along with signed copies of all required Federal Income Tax Returns (first two pages of Form 1040) to HR Shared Services. Please note, documents must be submitted via email in order to ensure receipt.

If your application for Schedule B Medical Rates is approved, you will be notified via email to your account. You must re-apply each year for Schedule B Medical Rates.

Should you have any questions, please reach out to our HR Shared Services team at 315.443.4042.

Every effort has been made to ensure that the information contained within this website is accurate. However, benefits are governed by legal documents (which, in certain circumstances, may include insurance contracts). If there is any difference between the information in this website and the official documents, the official documents will control. As is the case with all of Syracuse University’s employee benefit plans, the University reserves the right to modify or terminate these benefits at any time.