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Medical Benefits
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Benefits and Coverage

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Robert Van Keuren

Medical Benefits

The ICSD offers employees comprehensive medical plans through Excellus BlueCross BlueShield.

COVID-19 Coverage

ICSD employee benefits related to COVID-19 include the following:

-No cost to members for COVID-19 testing (where medically necessary/consistent with CDC guidance)
-No cost to members for medically necessary office, urgent care, or ER visits related to COVID-19
-No cost to members for telemedicine services (where plans include a telemedicine benefit)
-Early medication refills available for prescriptions during the state of emergency
-Waiver of early refills limits for 30 or 90-day supplies of medications
-Home delivery available for up to 90-day supply of medication at one time

To learn more, visit

2020-21 Health and Dental Insurance Rates
Classic Blue Benefit Grids
Enrollment Application with Addendum
HIPAA Authorization Form
Instructions to Submit HIPAA Authorization Online
Medical Claim Form
Prescription Drug Claim Form


All employees covered by the ICSD insurance plan can receive care 24/7 via telemedicine. This service is provided by MDLIVE, a partner of Excellus BlueCross BlueShield. 

COVID-19 Update: Telehealth Visits Covered in Full

Normally, telemedicine visits follow the deductible and copay schedule outlined in your BCBS plan, however, in an effort to free up provider offices, urgent care centers, and hospitals and keep people home, all telehealth visits (not just those related to the coronavirus) are now covered in full for all groups in New York State for the duration of the state of emergency.

Telemedicine Services FAQs
Telemedicine Services - BCBS
MDLIVE Overview
MDLIVE Registration Card

Vision and Dental Benefits

The ICSD offers employees vision and dental plans, administered by Ameritas. The FUSION plan combines dental and eye care benefits in one easy-to-administer plan.

2020-21 Health and Dental Insurance Rates
FUSION Highlight Sheet
Dental & Vision Transition Information
Dental Benefits Handout
Dental Claim Form
Dental Enrollment/Change/Waiver Form
Eye Care Highlight Sheet
Vision Benefits Handout
Vision Enrollment/Change/Waiver Form
Vision/Fusion Claim Form
Notice of Privacy Practices
English Version
Spanish Version
Once you've been enrolled in the Ameritas group plan, you'll receive a certificate outlining your benefits. Contact Ameritas if you haven't received a certificate. You can also access benefit information online by signing into your member account. Upon request, Ameritas will provide members with a paper copy of their certificate.

Flexible Spending Accounts

The ICSD partners with Pro-Flex Administrators LLC to offer employees Flexible Spending Accounts (FSA). This benefit allows employees to pay for everyday health care, dependent care expenses, and certain individual premium expenses with pre-tax dollars.

Direct Deposit Agreement
Direct Deposit Enrollment Form
Eligible Expenses List
FAQ - FSA with Rollover
FSA Enrollment Form
Mobile App Information
Website & Mobile App Access Info

Prescription Benefits

The ICSD offers employees prescription benefit plans, administered by Express Scripts.

Notice of Privacy Practices

403(b) Benefits

US OMNI offers a supplemental retirement plan that gives you the option to save money from your paycheck on a pre-tax basis while allowing your money to grow tax-deferred until retirement. 

403(b) Salary Reduction Agreement Form
ICSD Approved List of 403(b) Companies
Universal Availability Notice