| Class | Benefit Summary | Summary of Benefits & Coverage | Prescription Plan* |
|---|---|---|---|
| Active Employees | Platinum Plan | Platinum Plan |
$ 5/35/70 Retail $ 10/70/140 Mail |
| Retiree Group |
Classic Blue Plan 100/200 (3T7)
|
$ 5/35/70 Retail $ 10/70/140 Mail $ 5/10/25 Retail $ 10/20/50 Mail
|
*Prescription Plan is linked to Drug Formulary
* To view Participating Providers and your subscriber information please sign on to your Excellus account