Confidential, Management, and Elected Officials

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, 151KB)

• Rates
  • Individual Per Pay Period $95.58
  • Family Per Pay Period $248.51

TC Core Benefits Change Form(PDF, 222KB)

• Dutchess Dental Summary Document(PDF, 153KB) - 2025 Rate: $168.67/Month (100% Employee Paid). As of 7/1/2025 that rate with change to $170.36 per month.
• TC Core Benefits Change Form(PDF, 222KB)
• Excellus BCBS Dental Blue Options(PDF, 112KB) - Low Option Summary Document - 2025 Rates: $35.42/Month Individual; $93.04/Month Family (100% Employee Paid)
• Excellus BCBS Dental Blue Options(PDF, 114KB) - High Option w. Ortho Summary Document - 2025 Rates: $46.46/Month Individual; $122.06/Month Family (100% Employee Paid)
• Excellus BCBS Dental Blue Options Enrollment Form(PDF, 508KB)

2025 Rate: $24.34 Per Month (100% Employee Paid)

• Platinum Vision Summary Document(PDF, 129KB)
• TC Core Benefits Change Form(PDF, 222KB)

2025 Platinum Plan Excellus BCBS Summary Document(PDF, 151KB)

• Rates
  • Individual Per Pay Period $95.58
  • Family Per Pay Period $248.51

TC Core Benefits Change Form(PDF, 222KB)

• Dutchess Dental Summary Document(PDF, 153KB) - 2025 Rate: $168.67/Month (100% Employee Paid). As of 7/1/2025 that rate with change to $170.36 per month.
• TC Core Benefits Change Form(PDF, 222KB)
• Excellus BCBS Dental Blue Options - Low Option Summary Document(PDF, 112KB) - 2025 Rates: $35.42/Month Individual; $93.04/Month Family (100% Employee Paid)
• Excellus BCBS Dental Blue Options - High Option w. Ortho Summary Document(PDF, 114KB) - 2025 Rates: $46.46/Month Individual; $122.06/Month Family (100% Employee Paid)
• Excellus BCBS Dental Blue Options Enrollment Form(PDF, 508KB)

2025 Rate: $24.34 Per Month (100% Employee Paid)

• Platinum Vision Summary Document(PDF, 129KB)
• TC Core Benefits Change Form(PDF, 222KB)