White Collar

Classic Blue Excellus BCBS Summary Document(PDF, 1MB)

• Rates:
  • Individual Per Pay Period $287.97
  • Family Per Pay Period $479.14
• Rx Co-Pay - $5/$20/$35, 2x @ Mail

Blue PPO Excellus BCBS Summary Document(PDF, 221KB)

• Rates
  
  • Individual Per Pay Period $278.05
  • Family Per Pay Period $456.18

• Rx Co-Pay - $5/$20/$35, 2x @ Mail

Platinum Plan Excellus BCBS Summary Document(PDF, 155KB)

• Rates
  • Individual Per Pay Period $ 83.84
  • Family Per Pay Period $217.99
• Rx co-pay: $5/$35/$70, 2x @ Mail

Health Insurance Enrollment Form and Dependent Eligibility(PDF, 1007KB)

2024 Rate - $167.00 per month - 100% Employee Paid

• Dutchess Dental Summary Document(PDF, 191KB)

2024 Rate - $24.34 Per Month - 100% Employee Paid

• Platinum Vision Summary Document(PDF, 117KB)
• Dutchess Dental/Platinum Vision Enrollment Form(PDF, 176KB)

• Flexible Spending Account Information(PDF, 620KB)
• Flexible Spending Account Enrollment Form(PDF, 100KB)

Platinum Plan Excellus BCBS Summary Document(PDF, 172KB)

• Rates
  • Individual Per Pay Period $ 83.84
  • Family Per Pay Period $217.99
• Rx co-pay: $5/$35/$70, 2x @ Mail

Health Insurance Enrollment Form and Dependent Eligibility Verification(PDF, 1007KB)

2024 Rate - $167.00 Per Month - 100% Employee Paid

• Dutchess Dental Summary Document(PDF, 191KB)

2024 Rate - $24.34 Per Month - 100% Employee Paid

• Platinum Vision Summary Document(PDF, 117KB)
• Dutchess Dental/Platinum Vision Enrollment Form(PDF, 176KB)

• Flexible Spending Account Information(PDF, 620KB)
• Flexible Spending Account Enrollment Form(PDF, 100KB)