Health Insurance Information

Table Of Contents:
You will find links below for each item listed.  If you have questions, please contact the Personnel Office.


To view the Open Enrollment Poster click link above.

Franklin County Employees

Please click the link above to review the Notice of Privacy Practice. 

HIPAA Authorization (PDF - 382.6 KB)
Please click the link above for a copy of the “Authorization to Designate form from Excellus BC/BS.


In order to allow another to discuss information with Excellus BC/BS and the Franklin County Personnel Office, the Authorization to Designate form must be completed for each relevant member and dependent.

  ▪ The individual (employee, spouse or dependent) seeking to designate another individual to discuss his/her health records must complete Part A as the Member.  The individual being authorized to discuss health matters is listed in Part B of the form.

  ▪ In Part C and Part D, please make sure to check the appropriate box(es).  Any boxes that are not checked, Excellus BC/BS will not release any information to your designee about these medical issues.

  ▪ In Part E, please make sure to sign and date the form for proper processing.


As a reminder, if these forms are not filed with the Personnel Office or Excellus BC/BS, neither office will be able to discuss any health information regarding your coverage, claims, benefit information, etc. with anyone other than the covered individual.


If you are not able to print the forms, please contact the Personnel Office. 

Once completed, please return the form to the Personnel Office or the address listed on the bottom of the form. 

Please feel free to contact the Personnel Office at (518) 481-1665.

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