Tuition Remission, COBRA, EOB, R&C FAQs
What is Tuition Remission?
What are the eligibility requirements for Tuition Remission?
In order to be eligible for Tuition Remission you must be a full-time, regular employee in an eligible job category. Your spouse/registered domestic partner and dependent children (age 23 or younger as of the end of the calendar year) are also eligible to participate in the Tuition Remission Program. Retired employees who meet University eligibility requirements and retirement criteria are eligible for the same Tuition Remission benefits for which they were eligible immediately prior to retirement. Certain former employees and their dependents who meet the service and eligibility requirements may be eligible for Tuition Remission (see Separation Policy).
You must be accepted and matriculated in an NYU degree, maintain the same academic standards as any other applicants or students, and must comply with all student rules and regulations. Certain waiting periods may apply.
What expenses are covered by Tuition Remission?
Tuition Remission covers 50% to 100% of tuition, the largest expense of attending NYU. For employees, the benefit will also cover 50% of the course registration fees. Spouses/registered domestic partners and dependents will pay 100% of the course registration fees. In addition, you are responsible for service fees, or any other incidental expenses. (Refer to the Tuition Benefits plan documents for your employee code: Faculty or Employee.)
Is proof of relationship required when family members apply for Tuition Remission?
When you apply for Tuition Remission for your spouse, registered domestic partner, or dependent child (age 23 or younger as of the end of the calendar year) for the first time, be prepared to provide a copy of their birth certificate, your marriage certificate or domestic partnership registration as proof of the relationship. You may register your domestic partner with the NYU Benefits Office, if you have not already done so. Their Social Security number will also need to be on record. Note: Employees using the Tuition Remission benefit for spouses and children must add them as dependents in the Benefits Resource Center even if they are not enrolling them in any other benefits.
When you apply for Tuition Remission for your dependent child for the first time, be prepared to submit a copy of their birth certificate and proof of dependency (e.g. a tax return). Note: A dependent child (age 23 or younger as of the end of the calendar year) means your biological or legally adopted child, your stepchild, or the child of a registered domestic partner whom you claim as a dependent when filing income tax.
What is Special Student Status?
Special Student Status may be granted when your acceptance into a degree program is pending, because
- Prerequisite course work is needed and these prerequisite courses will be taken as a Special Student.
- Additional paperwork is needed to complete your application for matriculation into a degree program.
How many credits are allowed each year?
Tuition Remission eligible employees and their spouses/registered domestic partners are granted nine credits of tuition remission per term (or the equivalent of nine credits for non-credit courses at SCPS), for a total of 27 per academic year. The employee or spouse/partner may carry over up to three unused credits from one term to the next within the same academic year, providing that the total for the academic year (September 1-August 31) does not exceed 27. The summer is counted as one semester for Tuition Remission purposes, although individual schools may divide it into a number of sessions for course scheduling.
Any credit limits stated may be superseded by a regulation of a particular department, school, or college that permits fewer credits.
Can credits be carried over from one term to the next?
Only credits earned but not used may be carried over. There can be no borrowing of a future term's credits.
Three unused credits from the fall may be carried over to the nine for the spring for a total Tuition Remission benefit of 12 for the spring term. Three unused credits from the spring may be added to the summer 9 credits for a total of 12 for the summer term. Unused credits from the summer may not be carried over to the fall because the fall is a new academic year.
What programs at NYU are available under Tuition Remission?
You, your spouse, or your registered domestic partner, and your dependent children may use Tuition Remission for eligible degree programs at NYU.
In addition, as an employee, you may receive full or partial Tuition Remission for diploma programs, certificate programs, approved work-related courses, and non-credit non-work-related programs at the School of Continuing and Professional Studies (SCPS). You are also eligible for Tuition Remission for certificate and diploma programs at degree-granting schools.
Tuition Remission is not available for courses in the School of Law, School of Medicine, Post Graduate Medical School, Stern School of Business (except the Langone part time MBA program which is available to employees but not spouses, registered Domestic Partners, dependent children and retirees), or for certain courses in the School of Continuing and Professional Studies (SCPS). Tuition Remission is not available at the College of Dentistry, except for the AAS in Dental Hygiene, BS in Dental Health Education, MS in Biomaterials, MS in Clinical Research, and MS in Bio/Oral Bio Programs.
Is Tuition Remission considered taxable income?
Whether the Tuition Remission benefit is taxable is based upon the Program in which you or your eligible family member is enrolled, according to IRS regulations.
In general, you do not have to pay income tax on Tuition Remission benefits for undergraduate degree programs for yourself, your spouse and your dependent children (age 23 or younger as of the end of the calendar year).
Because the IRS does not recognize the tax exemption of benefits extended to domestic partners, all Tuition Remission for registered domestic partners and their dependent children is considered taxable.
Under IRS regulations, up to $5,250 per year of graduate Tuition Remission benefits for employees are non-taxable. This means the first $5,250 of your graduate tuition costs will not be taxed. Anything over $5,250 will be considered taxable income, and the tax on the value of the benefit will be withheld from your paycheck. If the graduate level course work is job-related, it will be excluded from taxable income.
Under IRS regulations, any graduate-level Tuition Remission benefits for a spouse/ registered domestic partner, or dependent children are fully taxable.
How do I apply for Tuition Remission?
NYU employees can apply for Tuition Remission online through the Tuition Remission System and process requests for themselves or eligible family members. To find the Tuition Remission System, log on to home.nyu.edu, click on the Work tab, then log in to Administrative Systems. The Tuition Remission System can be used to apply for degrees at all NYU schools and programs eligible under Tuition Remission, with the exception of SCPS non-credit courses. Employees still need to submit a paper Tuition Remission Form for SCPS non-credit courses.
Former NYU employees and Retirees still need to use a paper Tuition Remission Form.
What if I can't find the Tuition Remission System?
If the link to the Tuition Remission System is not displayed on the Administrative Systems screen, you will need to contact ITS Client Services at (212) 998-3333.
Note: You will need to allow at least one business day after registration (two days if you are a Stern Graduate Student) before applying for Tuition Remission.
Continuation of Coverage under COBRA
What is COBRA?
COBRA (the Consolidated Omnibus Budget Reconciliation Act of 1986) provides certain former employees, retirees, spouses, former spouses, and dependent children the right to temporary continuation of health coverage at group rates, when coverage is lost due to certain specific events.
When is someone entitled to get coverage under COBRA?
COBRA establishes specific criteria for plans, qualified beneficiaries, and qualifying events. Generally, an employee, or the employee's spouse, or dependent children who are covered by an NYU group health plan and lose coverage due to a "qualifying event" are eligible to continue coverage under COBRA.
In certain cases, a retired employee, the retired employee's spouse, and the retired employee's dependent children may be eligible for COBRA.
How do I find out about COBRA coverage and how do I elect to take it?
Shortly after you become covered under a medical plan, you will receive a General Notice of COBRA Coverage Rights. Upon termination of employment for any reason other than your gross misconduct, you will receive a COBRA Notification/Election Form. You must respond to this notice and elect COBRA coverage on or before the 60th day after the written notice is sent, or the day health care coverage ceased, whichever is later. Otherwise, you will lose all rights to COBRA benefits. If your covered dependent loses coverage due to a Qualifying Event, you must contact the Benefits Office to request a COBRA Notification/Election Form within 60 days of the event or your dependent loses all rights to COBRA benefits.
What is a qualifying event?
Examples of qualifying events are:
- Voluntary or involuntary termination of the covered employee's employment for any reason other than gross misconduct
- Reduction in the hours worked by the covered employee
- Divorce or legal separation of the covered employee
- Death of the covered employee
- Loss of dependent child status under the plan rules.
How long can I continue coverage under COBRA?
You will generally be eligible for coverage for a maximum of 18 months if the qualifying event is due to employment termination or reduction of hours of work. Certain qualifying events, such as loss of coverage due to a divorce, or a second qualifying event during the initial period of coverage, may allow you to receive a maximum of 36 months of coverage.
What happens when my child is no longer eligible for coverage under my NYU health plan?
Your dependent child will become eligible to continue coverage under COBRA for up to 36 months if they lose coverage under the plan.
How long after a qualifying event do I have to elect COBRA coverage?
Once you or your dependent(s) have become a "qualified beneficiary," you will be given an election period of at least 60 days, during which you may choose whether to elect COBRA coverage.
Each qualified beneficiary may independently elect COBRA coverage or you or your spouse may elect COBRA coverage on behalf of all other qualified beneficiaries.
If I waive COBRA coverage during the election period, can I still get coverage at a later date?
If you waive COBRA coverage, you may revoke the waiver if you do so before the end of the election period. After the 60-day election period, your eligibility to elect to continue coverage under COBRA will end.
How much will COBRA coverage cost?
When you were an active employee, your employer may have paid all or part of your group health premiums. Under COBRA, as a former employee no longer receiving benefits, you will usually pay the entire premium amount, that is, the portion of the premium that you paid as an active employee and the amount of the contribution made by your employer. In addition, there may be a 2 percent administrative fee.
As a Plan participant under COBRA, you will remain subject to the rules of the plan, including copayments and deductibles, and are subject to all Plan limits and maximums.
I have COBRA. Do I need Medicare?
Yes, COBRA is always secondary to Medicare. This means that it only pays after Medicare pays. If you do not enroll in Medicare when you become eligible for it, it will be as if you have no insurance.
If you have Medicare first and then become eligible for COBRA, you can enroll in COBRA. If you have COBRA first and then become eligible for Medicare, COBRA will not usually continue your benefits. You should enroll in Medicare as soon as you are eligible.
Can I have both COBRA and Medicare?
Whether you can have COBRA and Medicare depends on which one you had first. If you have COBRA and then become eligible for Medicare, your COBRA may end. If you have Medicare and then become eligible for COBRA, you can sign up for COBRA insurance and it will be secondary to Medicare.
How to Read Your Explanation of Benefits (EOB)
What is an Explanation of Benefits (EOB)?
The Explanation of Benefits (EOB) is a notification that a claim has been processed by your insurance company. It is not a bill.
Why do I need an EOB?
Your EOB is an important record of the services you received. It shows the date(s) you received the service, the amount that was billed by your provider, the amount that was paid, what copayments were applied to the bill, how much was credited to your annual deductible (if applicable), and the portion of the charges that were not paid.
How do I read the EOB?
Your insurance company tries to make the explanation easy to understand. However, the layout and design of EOB's from different insurance companies may be slightly different.
Generally, there are four major sections on any EOB:
1) Claimant Information:
- The name, address, and phone number of the insurance company who received the claim
- The name of the individual who has the insurance (member's name)
- The name of the patient
- The group number for the NYU insurance plan
- The claim number
2) Service and Coverage Information:
- The date(s) when services were performed
- Codes that identify the type of service provided
- The amount charged
- Deductibles and/or copayments that apply
- The amount that was or will be paid
- The balance that will be the responsibility of the patient
- additional information that you need to know about the claim. For example, if the claim was not paid in full, the EOB will note the benefit limitations or exclusions that apply
4) Patient Summary:
- Total billed
- Total benefits approved for payment
- Amount that may be owed to the provider.
What are Reasonable & Customary (R&C) Charges?
Reasonable & Customary (R&C) charges are the normal range of fees for services charged by health care providers in your given geographic area. Expenses in excess of the R&C are not reimbursed by the Plan. (See also, "Explanation of Reasonable & Customary Charges".)
What is a "Pended Claim"?
At times, a claim might be "pended" for additional information, either from you or from the provider of services. If any of your claims are pended, you need to be sure to take any additional steps required to properly resolve your claim.
I have a United HealthCare (UHC) plan and received a form called a Health Statement. Is this the same as an Explanation of Benefits (EOB)?
Yes, this is a new version of an EOB that UHC provides its members. In addition to the standard information listed above, the UHC Health Statement also provides personal information , from saving money on your course of treatment to reminders about immunizations and tests needed by you or your dependents.
What should I do with the EOB?
Each time you receive an EOB, you should review it closely and compare it to the receipt(s) or statement(s) that you received from your providers. You may receive more than one EOB if more than one physician or service provider was involved in your treatment. For example, if an x-ray was taken when you visited your doctor, both your doctor and the laboratory may bill your insurance company separately depending on how your health plan covers lab and X-ray procedures.
Should I save all my Explanation of Benefits (EOBs)?
Yes. It is a good idea to save your EOBs for at least a year in case questions come up about a particular claim. In addition, if you participate in a Health Care Flexible Spending Account (FSA) you may need your EOB to substantiate an expense you have submitted for reimbursement under the FSA plan.
Explanation of Reasonable & Customary (R&C)
What are Reasonable & Customary (R&C) charges?
Reasonable & Customary (R&C) charges are the normal range of fees for services charged by health care providers in your given geographic area (based on the zip code where the provider has their practice.) The NYU Point-of-Service Plans use a national database of health care provider charges to determine the Plans' R&C allowances.
An average price for R&C charges is determined for a particular zip code, any charges above that average are considered above R&C.
Are expenses that are above the R & C allowance credited to my annual deductible?
Expenses in excess of the R&C allowance are not reimbursed by the Plan, nor do they count toward your annual deductible or the Plan's out-of-pocket maximum.
You should contact your health care provider if you need to know whether a charge for a given procedure code is within the R&C allowance.
What happens if I go out of network?
If you are enrolled in one of the NYU Point-of-Service Plans, and you go out of network, any amounts your provider charges, which are above Reasonable & Customary or contracted rates, are your responsibility and are not credited to your annual deductible.
The Aetna and Oxford HMO Plans cover in-network services only.