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 - A
2022 Blue PPO (PDF) 

Blue PPO 2 - B
2022 Blue PPO 2 (PDF)

Blue PPO 3 - J
2022 Blue PPO 3 (PDF) 


Classic Blue (Indemnity) - C
2022 Classic Blue (Indemnity) (PDF) 


Glossary of Health Coverage and Medical Terms (PDF)