Reduced Medical Rates: Schedule B

Benefits-eligible employees enrolled in the Syracuse University medical plan automatically pay the Schedule A medical rates unless they qualify, apply and are approved for reduced Schedule B rates. Certain employees represented by the SEIU collective bargaining agreement are automatically enrolled in the Schedule B medical rates.

On this page:

Eligibility

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

For 2019, the criteria is as follows:

Household SizeHousehold Income
1Less than $36,000
2Less than $49,000
3Less than $62,000
4 and upLess than $75,000

For 2020, the criteria is as follows:

Household SizeHousehold Income
1Less than $37,000
2Less than $51,000
3Less than $64,000
4 and upLess than $77,000

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 1 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 2020 is Dec. 6, 2019.)

  1. Complete either the 2019 Syracuse University Application for Schedule B Medical Contributions [PDF] (to received benefits in calendar year 2019) or the 2020 Syracuse University Application for Schedule B Medical Contributions [PDF] (to receive benefits in calendar year 2020).
  2. Submit the completed application, along with signed copies of all required Federal Income Tax Returns (first 2 pages of Form 1040) to HR Shared Services. Please note, documents must be submitted via email or in person in order to ensure receipt.
    • Email your application and scanned tax returns to hrservice@syr.edu or bring your application and tax returns to HR Shared Services (located in Skytop Office Building).

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

Helpful Links

Questions? Contact HR Shared Services at 315.443.4042 or email hrservice@syr.edu.


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.