• Excellus PPO Be sure that you are eligible for the PPO Plan.
• Hybrid
• HDHP & HSA Deposit
• Pre Tax Acceptance Or Declination Form *must accompany any enrollment form
• Opt Out Enrollment Form

BENEFIT SUMMARIES:

1. Lewis County 2024 Excellus Benefit Summary BluePPO
2. Lewis County 2024 Excellus Benefit Summary SimplyBlue Hybrid 
3. Lewis County 2024 Excellus Benefit Summary SimplyBlue HDHP

Dental information

1. 31 Sunrise Dental & CSEA EBF Enrollment Form -available for CSEA members and non members. CSEA Sunrise: $40.32
2. Guardian Dental Enrollment Kit For Lewis County-available for all employees. Guardian: Individual $11.36     Family: $34.06

Vision information

34 Gold Vision & CSEA Vision Enrollment-Individual $9.67     Family $26.06

Flex Spending

For Medical/Health and Dependent Care- Enrollment Form & Direct Deposit Form  

If you have any questions call JJ Hodkinson, Benefits Specialist at 315-376-5323 or email joycehodkinson@lewiscounty.ny.gov