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Insurance

David Dreidel, CPA
Administrator of Benefit Services, State Aid Planning & Capital Accounting
(315) 792-2218

Open Enrollment 2025-2026

2025-2026 UCSD Open Enrollment Booklet.pdf

684.07 KB, uploaded May 5, 2025 8:54 AM

Excellus BCBS Enrollment Form.pdf

1.09 MB, uploaded May 5, 2025 8:54 AM

Health & Dental Insurance Tax Deduction Form.pdf

585.05 KB, uploaded May 5, 2025 8:54 AM

Open Enrollment Active Employee Memo.pdf

445.3 KB, uploaded May 5, 2025 8:54 AM

PG Blue FSA Enrollment Form.pdf

771.38 KB, uploaded May 5, 2025 8:54 AM

Active

01 - 25-26 UCSD BEPO Benefit Summary.pdf

39.56 KB, uploaded November 6, 2025 9:16 AM

(opens in a new window)

02 - 25-26 UCSD Hybrid Benefit Summary.pdf

41.76 KB, uploaded November 6, 2025 9:16 AM

(opens in a new window)

03 - 25-26 UCSD Classic Blue Benefit Plan Summary.pdf

58.54 KB, uploaded November 6, 2025 9:16 AM

(opens in a new window)

24-25 UCSD Medical & Dental Enrollment Form.pdf

1.09 MB, uploaded September 23, 2024 7:54 AM

(opens in a new window)

Dental Blue Options Summary.pdf

698.8 KB, uploaded November 13, 2025 9:08 AM

(opens in a new window)

Waiver form.pdf

368.47 KB, uploaded June 17, 2024 11:52 AM

(opens in a new window)

Retirees

Dental Blue PPO Retirees Benefit Grid (003).pdf

78.46 KB, uploaded May 23, 2024 1:20 PM

UCSD Classic Blue Secure Grids 2024.pdf

314 KB, uploaded June 26, 2024 8:25 AM

UCSD Medicare Advantage Plan.pdf

185.1 KB, uploaded May 23, 2024 1:20 PM

Other Helpful Information

24-25 UCSD Medical Plan Comparison.pdf

95.06 KB, uploaded October 1, 2024 12:54 PM

Customer Care Flyer.pdf

354.63 KB, uploaded November 4, 2024 4:37 PM

Find A Doctor Member Factsheet.pdf

286.76 KB, uploaded November 4, 2024 4:37 PM

Pharmacy Information.pdf

2.86 MB, uploaded October 1, 2024 12:54 PM

Primary Care Provider Flyer.pdf

335.82 KB, uploaded November 4, 2024 4:37 PM

Qualifying Events Checklist.pdf

35.59 KB, uploaded September 23, 2024 7:54 AM

Register your Excellus BCBS Account.pdf

147.83 KB, uploaded October 1, 2024 12:54 PM

Telemedicine Virtual Care Options.pdf

154 KB, uploaded November 4, 2024 4:37 PM

UCSD Telemedicine Flyer.pdf

603.74 KB, uploaded October 1, 2024 12:54 PM

Where to Go for Care.pdf

143.65 KB, uploaded November 4, 2024 4:37 PM

BCBS medical insurance forms are available at: https://www.excellusbcbs.com/contact/print-forms

Human Resources

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Utica City School District

929 York Street
Utica, NY 13502
315-792-2210

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