Town of Caroline Plan Information

Subscribers Benefit Summary        Summary of Benefits & Coverage Prescription Plan*
Actives & Cobra   Signature Gold Integrated Signature Gold Integrated $  5/35/70 Retail
$10/70/140 Mail  
Actives & Cobra  Signature Bronze Integrated Signature Bronze Integrated $  5/35/70 Retail
$10/70/140 Mail
Actives & Cobra  Signature Platinum Signature Platinum $  5/35/70 Retail
$10/70/140 Mail
Actives & Cobra  $10 PPO  $10 PPO $  5/25/40 Retail
$20/50/80 Mail
Retirees Classic Blue Supplement    $10/25/40 Retail
$20/50/80 Mail  

*Prescription Plan is linked to Drug Formulary
* To view Participating Providers and your subscriber information please sign on to your Excellus account