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Health Insurance – Excellus BCBS

Rates
Enrollment Form
Telemedicine for Medical and Behavioral Health
Option 1: Healthy Blue with HSA & Healthy Rewards
Option 2: Simply Blue – without HSA funding
- General Benefits Summary
- Simply Blue SBC
Option 3: Blue PPO - For Medicare Eligible Only
- General Benefits Summary
- Blue PPO SBC
Health Insurance Waivers
Compliance Documents

Website: www.excellusbcbs.com
Phone Number: 1-800-499-1275

Prescription Coverage - OptumRX

Website: www.OptumRx.com
Phone Number: 1-855-265-0191

Dental Insurance – Guardian Dental

Website: www.guardianlife.com
Phone Number: 1-800-541-7846

Vision Insurance – Davis Vision

Website: www.davisvision.com
Phone Number: 1-800-999-5431

Flexible Spending Account (FSA) – Lifetime Benefit Solutions

Website: www.lifetimebenefitsolutions.com
Phone Number: 1-800-327-7130

TIAA Retirement

Website: TIAA.org/Utica
Phone Number: 800-842-2252

Representative:
Mark Couch, TIAA Financial Consultant
Phone: (866) 698-4221
Email: mcouch@tiaa.org

Employee Assistance Program (EAP) – NextGen

Member Guide

Website: www.nexgeneap.com (Company ID: 9000)
Phone Number: 1-800-EAP-CALL

Voluntary Insurance

UNUM Website: www.UNUM.com
UNUM Phone Number: 1-800-275-8686
Prudential Website: www.prudential.com
Prudential Phone Number: 1-877-232-3619

Miscellaneous

Transparency in Coverage

This notice is for all participants in Utica University's health insurance plan. Transparency in Coverage rules have been established by the Centers for Medicare & Medicaid Services (CMS). This regulation, which went into effect on July 1, 2022, requires health plans to post on their public website "machine-readable files" containing the following price information:

In-network provider contracted rates for items and services
Out-of-network allowed amounts and billed charges for items and services

Please note that these rates and charges are not set by Utica University, but rather are rates established between the insurance company and providers.

The rule requires employers to place a link on their benefits web page that directs visitors to machine-readable files on the Excellus Blue Cross Blue Shield website. The link is: https://www.excellusbcbs.com/transparency-coverage-mrf

Machine readable files are designated for a machine. As they are not user-friendly, we instead advise participants to login to their online account to access Excellus Blue Cross Blue Shield's Estimated Medical Cost Tools. For more information about the tool, please visit:

https://www.excellusbcbs.com/find-a-doctor/estimate-medical-costs

This tool will help most members estimate out-of-pocket costs based on the health insurance plan in which they are enrolled.

Behavioral Health Factsheet

Member Benefit Reminder

Previous Benefit Year Information