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 2020, the criteria is as follows:
|Household Size||Household Income|
|1||Less than $37,000|
|2||Less than $51,000|
|3||Less than $64,000|
|4 and up||Less 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).
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 was Dec. 6, 2019.
- Complete the 2020 Syracuse University Application for Schedule B Medical Contributions [PDF] (to receive benefits in calendar year 2020).
- 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 or in person in order to ensure receipt.
- Email your application and scanned tax returns to email@example.com 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.
- 2020 Syracuse University Application for Schedule B Medical Contributions [PDF]
- Monthly Medical Rates
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.