Employee Benefits

Cortland County's medical, dental and vision plans are administered by Excellus. https://www.excellusbcbs.com

Forms & Documents


  1. Authorization to Excellus Health Plan to Disclose Protected Health Information
  2. CanaRX (Cortland Meds) Enrollment Form
  3. CanaRx (Cortland Meds) Informational Flyer
  4. CHIPRA Notice
  5. Creditable Coverage Notice
  6. CSEA Dental Summary Plan
  7. CSEA Dental/Vision Enrollment Form
  8. CSEA Dental/Vision Rates 2024
  9. CSEA Vision Summary Plan
  10. Dental Benefit Summary
  11. Dental Claim Form
  12. Employee Assistance Program (Management, NYSNA, General CSEA Unit)
  13. Employee Assistance Program-(Road, Corrections, ERAC, Civil Only)
  14. Excellus (Davis) Vision Claim Form
  15. Excellus Dependent Certification Form
  16. Excellus Insurance Rates 2023
  17. Excellus Insurance Rates 2024
  18. Excellus Medical Claim Form
  19. Express Scripts Info
  20. Flexible Spending (FSA) Enrollment Form
  21. Flexible Spending Account- Informational Flyer
  22. Flexible Spending Reimbursement Form - Dependent Care
  23. Flexible Spending Reimbursement Form - Medical Expenses
  24. Health Insurance Benefits Summary- PPO Plan
  25. Health Insurance Benefits Summary- Traditional Plan
  26. Health Insurance Plan Document
  27. Health, Dental &Vision Insurance Enrollment Form
  28. MD LIVE
  29. New York State Deferred Compensation Enrollment Form
  30. Transparency in Coverage Rule - Machine Readable Files
  31. Vision Insurance Benefits