SBC & Glossary

Excellus Summary of Benefits & Coverage (SBC)

The following SBCs were prepared by Excellus utilizing the template format as required by the Healthcare Law. Please keep in mind, the document states that it is only a summary. The document also indicates that the required examples should not be utilized in estimating your actual costs under your plan.


Blue PPO - DKX
2026 Blue PPO (PDF)

Blue PPO 2 - AZY (DKY is same except Rx Copays are $20/35/65)
2026 Blue PPO 2 (PDF)

Blue PPO 3 - CPZ
2026 Blue PPO 3 (PDF)

Blue PPO 4 - FFU
2026 Blue PPO 4 (PDF)  - New Plan 1/1/26


Classic Blue (Indemnity) - DKZ
2026 Classic Blue (Indemnity) (PDF)

Glossary of Health Coverage and Medical Terms (PDF) 

Glossary of Health Insurance Terms | Excellus BlueCross BlueShield