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Insurance Plans


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Go to Insurance News to learn more about Excellus member log-in


EXCELLUS MEDICAL/HOSPITAL PLANS


A - BLUE PPO PLAN:     
      2021 Summary of Benefits - Click here
     
Participating Providers - go to your member log-in (once logged in, select Find A Doctor)   
      

B - BLUE PPO 2 PLAN:
      2021 Summary of Benefits - Click here
      Participating Providers - go to your member log-in (once logged in, select Find A Doctor)
     

J - BLUE PPO 3 PLAN:
     2021 Summary of Benefits - Click here
     Participating Providers - go to your member log-in (once logged in, select Find A Doctor)
     

C - CLASSIC BLUE (INDEMNITY) PLAN
     
2021 Summary of Benefits - Click here     
      Participating Providers - go to your member log-in (once logged in, select Find A Doctor)    
            


H, I - MEDICARE BLUE PPO PLAN:  
      2021 Summary of Benefits 
      H - High Option 
Click here.
                         In-Network
                         $15 office visit co-pays
                         90 day Rx = 1 co-pay
      I - Low Option  -
Click here.    
                         In-Network
                         $20 office visit co-pays
                         90 day Rx = 2 co-pays
       
       Participating Providers - go to your member log-in (once logged in, select Find A Doctor
       
       Silver and Fit Participating Providers - Click here


A, B, C, H, I, J - TELEMEDICINE:  Click here for information and then go to your member log-in
                           (once logged in, select Find A Doctor)


EXCELLUS PRESCRIPTION PLANS


A, B, C, J - EXCELLUS PRESCRIPTION PLAN INFORMATION:

       EXCELLUS 3-TIER MEDICATION LIST -
go to your member log-in                                                                      (once logged in go to prescriptions, check drug lists, under other plans offered through Employers                       choose 3-tier formulary)

       3-Tier Formulary Copays for Chemung County Plan Participants (by plan):
                          A, C                                      B                              J              
      Tier 1 - $15  | $20  | $25      Tier 1 - $10 | $15 | $20        Tier 1 - $10       
      Tier 2 - $30  | $35  | $40      Tier 2 - $25 | $30 | $35        Tier 2 - $25               
      Tier 3 - $60  | $65  | $70      Tier 3 - $55 | $60 | $65        Tier 3 - $55      

      Members that are REQUIRED to fill maintenance medications through mail order will have their
      Tier 1 copay waived when filled through Mail Order, except Plan J.

      *Chemung County employees refer to your union contract.

      LOCATE PARTICIPATING Rx PROVIDERS:  Pharmacy Search- go to your member log-in
      (once logged on choose prescriptions)
                
      MANDATORY MANDATORY MEDICATION LIST:  for members required to use mail order benefit
      go to your member log-in (once logged in go to prescriptions, check drug lists, under mandatory                         maintenace medication lists, choose the list of medications...)

      2021 PRESCRIPTION PLAN/MAIL ORDER INFORMATION - Click here  
 

H, I - MEDICARE D PRESCRIPTION PLANS INFORMATION:

     
Medicare D 3-Tier Formulary Copays for Medicare Blue PPO Plan Participants:
           H, I                            
     
Tier 1 - $10               
      Tier 2 - $25               
      Tier 3 - $40               
     
      LOCATE PARTICIPATING MEDICARE D PROVIDERS:  Medicare D Rider - go to your member log-in


EXCELLUS DENTAL PLAN       

D
- DENTAL PLAN INFORMATION - Dental coverage through Excellus begins 7/1/2020.  All claims incurred 7/1/2020 and after will be sent to Excellus utilizing your new Excellus dental ID card.  

       Dental Plan Summary - click here 



lbs-logo 

Lifetime Benefit Solutions (LBS)
VISION PLANS

D - DENTAL PLAN INFORMATION: - Dental coverage through LBS ended 6/30/2020.  The deadline to submit all claims incurred prior to 7/1/2020 was 10/31/2020.  Coverage is now provided through Excellus Dental.
      Plan Document - Click here
      

E - VISION PLAN INFORMATION:
      (except County CSEA, CSEA Health Center, Sewer District Union Employees)

      Plan Document - Click here
      Plan Summary - Click here

G - VISION PLAN 2 INFORMATION:  <For members enrolled in Blue PPO 2-B or Blue PPO 3-J>    
      (except County CSEA, CSEA Health Center, Sewer District Union Employees)

      Plan Summary - Click here

csea 

CSEA PLATINUM 12 VISION PLAN


F
- CSEA PLATINUM 12 VISION INFORMATION:
     
(for CSEA, CSEA Health Center or Sewer District Union Employees only)
     
Effective 7/1/2020 CSEA Platinum 12 Vision (EBF) has changed their eligibility rules for this vision plan.  Please contact CSEA Platinum 12 (EBF) directly for more information and directions on how to add dependents to this policy.  These eligiblity rules only apply to this vision plan.

      Plan Summary - Click here
      Participating Providers - Click here