The medical insurance program for benefit-eligible employees is offered through Aetna.

Excellus provides two plans to choose from:

a) Excellus Blue PPO (In-and Out-of-Network coverage)
b) Excellus Simply Blue High Deductible Health Plan (Health Savings Account and High Deductible Plan with In-and Out-of-Network coverage)

Excellus Medical Enrollment/Change Form

Excellus HSA Payroll Deduction Form - coming soon!

Excellus Healthcare Claim Form - coming soon!

c) Prescription drug coverage for Excellus Blue PPO plan participants will be provided by Express Scripts, Inc. With this change participants enrolled in this plan will receive a separate pharmacy ID card and a welcome package in mid-December. Participants should present your new pharmacy ID card each time you fill a prescription either through retail outlet or through the mail order program. If you are enrolled in the Excellus Simply Blue High Deductible Health Plan the prescription drug coverage will be provided by Excellus.

Express Scripts FAQ

Express Scripts Home Delivery Information

Express Scripts Mobile App Information

Express Scripts National Preferred Formulary

2015 Medical Bi-Weekly Payroll Deduction Rates

2015 Faculty & Administrative Bi-Weekly Paycheck Rates

2015 Administrative Hourly Bi-Weekly Paycheck Rates

2) Faculty/Administrative Employees' Medical Opt-Out (you must re-enroll annually)

More information on Excellus

Log on to Excellus BlueCross BlueShield Find A Doctor directory at www.excellus.com to select a participating physician. Additionally, you can call the Members Services number listed on your Excellus ID card.

Other information:

An open enrollment period is held once each year, usually in the fall, during which employees may enroll or change coverage with no restrictions.

Upon termination of employment, options for continuing coverage will be offered in accordance with federal regulations.

For further details, refer to the Summary Plan Description or contact Human Resources at ext. 3312.



The benefit plans summarized on these web pages are guidelines only. Every effort has been made to make these descriptions as brief, accurate and easy to understand as possible. Therefore, all details may not be described here. If there is a difference between the information in this publication and the official plan documents, the official plan documents will govern. In addition, the Colleges retain the right to supplement, modify, amend or eliminate benefit policies and plans. For more specific information, please contact the Office of Human Resources.