Human Resources
COVID-19 Affirmation of Isolation Form
COVID-19 Affirmation of Isolation Form This form should be completed when returning from COVID-19 isolation.
Summary of Benefits and Coverage - Excellus BCBS Classic Blue
The Summary of Benefits and Coverage (SBC) document shows you how you and the plan would share the cost for covered health care services. This is only a summary, for more information about your coverage, or to get a copy of the complete terms of coverage, call 1-800-499-1275 or visit ExcellusBCBS.com. See Summary of Benefits and Coverage here.
Medicare Part D Disclosure for 2022
This annual notice concerns the Medicare Part D prescription drug benefit for 2022. The information in this notice is for those eligible to enroll in Medicare Part D in 2022. If you will not be eligible for the Medicare Part D program in 2022, you may disregard this notice. See 2022 Medicare Part D Disclosure Notice here.
Families First Coronavirus Response Act Notice
The Families First Coronavirus Response Act (FFCRA or Act) requires certain employers to provide employees with paid sick leave or expanded family and medical leave for specified reasons related to COVID-19. The Department of Labor's (Department) Wage and Hour Division (WHD) administers and enforces the new law's paid leave requirements. These provisions will apply from the effective date through December 31, 2020. Please click on this link to view the required notice to employees regarding the Families First Coronavirus Response Act.
