Office of Human Resources
(315) 792-3276
Employee Benefits
Current information on employee benefits at Utica College.
Welcome to Open Enrollment for 2021
Note: Utica College’s Open Enrollment period begins November 1, 2020 through November 28, 2020. If you are not making any benefit changes for 2020 you do not need to do anything.
Section 1: Health Insurance
- 2021 Health Insurance Rates
- 2021 Health Insurance Enrollment Instructions
- 2021 Health Insurance Wavier Buyout
- 2021 HealthyBlue Forms
- 2021 Health Savings Account Contributions
- 2021 Health Savings Account (HSA) Contribution Schedule
- 2021 Health Savings Account (HSA) Salary Reduction Form (Qualifying Expenses are listed in Section 4, first bullet)
- 2021 Preventive RX Drug List
- 2021 Preventative RX Explanation
- 2021 Health Exchange Notice
- Rally Health Rewards Instructions
- 2021 SimplyBlue Enrollment Form
Please visit the Excellus BCBS website at www.ExcellusBCBS.com
Section 2: Dental Insurance
Please note: If you are not making changes to your current dental coverage, you do not need to complete new forms.
Section 3: Vision Insurance
Visit Davis Vision at www.DavisVision.com
Section 4: Flexible Spending Account (F.S.A.)
- 2021 Flexible Spending Enrollment Information
- 2021 Flexible Spending Qualifying Expense List
- 2021 Flexible Spending Enrollment Form
- 2021 Dependent Care Enrollment Form
- 2021 Flexible Spending Reimbursement Form
Section 5: TIAA
- TIAA Online Enrollment Instructions
- TIAA Information for Adjuncts
- TIAA Salary Reduction Form
- TIAA Defined Contribution Summary Plan Description
- TIAA Tax Deferred Annuity Summary Plan Description
Section 6: Voluntary Insurance
- Life AD&D LTD Highlight Sheet
- UNUM Term Life Highlight Sheet
- UNUM Term Life Enrollment Form
- Beneficiary Form
- Prudential Additional AD&D Rates
- Prudential Enrollment Form
Section 7: Employee Assistance Program (EAP)
New Name, More Services
1.800.EAP.CALL (1.800.327.2255)
NexGen (Employee Assistance Program):
1-800-327-2255
www.nexgeneap.com
Company ID: 9000 (Needed only to create an account on website.)
Section 8: Miscellaneous
Previous Benefit Year Information
Click here for a snapshot of the 2020 Benefits offerings
Section 1: Health Insurance
- 2020 Health Insurance Rate Information
- 2020 Health Insurance Enrollment Instructions
- 2020 Health Insurance Wavier Buyout Memo
- 2020 Health Insurance Wavier Buyout Form & Memo
- 2020 SBC Blue PPO Copay Plan
- 2020 PPO Summary of Benefits and Coverage
- 2020 SBC HealthyBlue $1800 with Healthy Rewards and HSA Funding
- 2020 HealthyBlue Summary of Benefits and Coverage
- 2020 HealthyBlue Enrollment Form
- 2020 Health Savings Account Contributions
- 2020 Health Savings Account (HSA) Contribution Schedule
- 2020 Health Savings Account (HSA) Salary Reduction Form (Qualifying Expenses are listed in Section 4, first bullet)
- 2020 Preventive RX Drug List
- Rally Health Rewards Instructions
- 2020 SBC SimplyBlue $1800 with no HSA Funding
- 2020 SimplyBlue (Low Cost Plan) Summary of Benefits and Coverage
- 2020 SimplyBlue Enrollment Form
Please visit the Excellus BCBS website at www.ExcellusBCBS.com
Section 2: Dental Insurance
Please visit Delta Dental at www.DeltaDentalIns.com
Section 3: Vision Insurance
Visit Davis Vision at www.DavisVision.com
Section 4: Flexible Spending Account (F.S.A.)
- 2020 Flexible Spending Enrollment Information
- 2020 Flexible Spending Qualifying Expense List
- 2020 Flexible Spending Enrollment Form
- 2020 FSA/LPFSA/HRA Medical Claim Reimbursement Form w/Instructions
Section 5: TIAA
- TIAA Online Enrollment Instructions
- TIAA for Adjuncts
- 2020 Salary Reduction Form
- Defined Contribution Summary Plan Description
- Tax Deferred Annuity Summary Plan Description
Section 6: Voluntary Insurance
Section 1: Health Insurance
- 2019 Health Insurance Rate Information
- 2019 Health Savings Account (HSA) Contribution Schedule
- 2019 HealthyBlue Summary of Benefits and Coverage
- 2019 PPO Summary of Benefits and Coverage
- 2019 SimplyBlue (Low Cost Plan) Summary of Benefits and Coverage
- 2019 Health Savings Account (HSA) Salary Reduction Form (Qualifying Expenses are listed in Section 4, first bullet)
- Health Savings Account - Requesting Funds in Advance
- 2019 Updated Preventive RX Drug List (HealthyBlue Plan Only)
- CHIPRA Notice
- Summary Plan Description 2015
- FAQ -What to Do If Your Doctor Asks For Money
- Publication 502
- Express Scripts Mail Order Prescription Information:
Please visit the Excellus BCBS website at www.ExcellusBCBS.com
Rally Healthy Rewards Program
- Rally Healthy Rewards Program Overview
- Rally Healthy Rewards Program FAQ
- Rally Healthy Rewards Screen Shots
Excellus Member Service:
CDHP: 1-800-499-1275
PPO: 1-800-765-5226
Medicare: 1-866-846-8643
Express Scripts: 1-855-315-5220
Rally: 1-877-726-1002
Bank of Utica HSA:
315-797-2700
AmeriCU Credit Union HSA:
Section 2: Dental Insurance
- 2019 Dental Insurance Rate Information
- 2019 Dental Highlight Sheet
- 2019 Dental Enrollment Form
- Summary Plan Description
- Claim Form
Please visit Delta Dental at www.DeltaDentalIns.com
Delta Dental:
Group Number: 10898
Division Number:
00001 (High Option)
00002 (Low Option)
Member Services: 1-800-932-0783
Section 3: Vision Insurance
- 2019 Vision Insurance Rate Information
- 2019 Vision Highlight Sheet
- 2019 Vision Enrollment Form
- Summary Plan Description
- Vision Claim Form
315-356-3000
Section 4: Flexible Spending Account (FSA)
- Items & Services Listing
- Participant Highlights
- 2019 Flexible Spending Enrollment Form
- 2019 FSA/LPFSA/HRA Medical Claim Reimbursement Form w/Instructions
- FSA - Request New/Additional Cards
Section 5: TIAA (Retirement)
- 2019 TIAA Plan Limits
- TIAA Enroll Online
- TIAA for Adjuncts
- 2019 Salary Reduction Form
- Investment Choices for TIAA
- Defined Contribution Summary Plan Description
- Tax Deferred Annuity Summary Plan Description
Section 6: College-Provided Life Insurance, AD&D Insurance and Long-Term Disability Insurance plus Voluntary AD&D Insurance
- Life, AD&D and Vol. AD&D Highlight Sheet
- Life Insurance Plan Booklet
- AD&D Plan Booklet
- Life Insurance Beneficiary Form and Coverage Election Form
- Vol. AD&D Enrollment Form
- The Business Council 2016 Summary Annual Report
- Long Term Disability Highlight Sheet
- Long Term Disability Plan Booklet
Section 7: Voluntary Term Life & Whole Life
Section 8: Employee Assistance Program
New Name, More Services
1.800.EAP.CALL (1.800.327.2255)
NexGen (Employee Assistance Program):
1-800-327-2255
www.nexgeneap.com
Company ID: 9000 (Needed only to create an account on website.)
Section 9: Miscellaneous
Contact Us
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For a general list of frequently used logins, you can also visit our logins page.