Pebtf - Enter your last name, date of birth and social security number. On the next screen, you will be able to Select your Payment – either pay in full or make a custom payment. Enter the card holder name, credit card number, expiration date and security code and click on Proceed to Checkout. Click on Complete Payment.

 
Services or supplies provided by a Hospital or Other Facility Provider, or by a Physician or Other Professional Provider that the Claims Payor - PPO, HMO, or Mental Health and Substance Abuse Plan Provider, or the PEBTF - determines are: (a) appropriate for the symptoms and diagnosis or treatment of the Member's condition, Illness, disease, or .... Happy birthday for women images

Enter your last name, date of birth and social security number. On the next screen, you will be able to Select your Payment – either pay in full or make a custom payment. Enter the card holder name, credit card number, expiration date and security code and click on Proceed to Checkout. Click on Complete Payment. The Bronze Plan is offered to non-permanent employees working an average of 30 hours a week. It offers both an in-network and an out-of-network benefit. You are responsible for the first $9,450 of in-network covered medical and prescription drug expenses for single coverage or $18,900 for family coverage. This is known as the annual deductible. PEBTF May Cancel Your Coverage For Fraud, Non-payment or Intentional Misrepresentation. IMPORTANT: If you intentionally provide false or misleading information about eligibility for coverage under the PEBTF Plan (or about a claim) or you fail to make a required contribution on time, your coverage may be terminated retroactively. This may occur ... The Pennsylvania Employees Benefit Trust Fund (PEBTF) offers confidential wellness screenings that give you valuable information about your health and health risks. You may then visit your doctor to discuss your results and set goals for better health. Your health and well-being are important to the PEBTF. Feb 1, 1997 ... Each Blue Cross Plan has sent a new ID card to all PEBTF members enrolled in the. Basic Option. The Pennsylvania Employee Benefit Trust Fund ...PEBTF for secondary coverage only. Any claims must be submitted to your spouse’s employer-sponsored health plan before they can be submitted for consideration of payment through the PEBTF health plans. The following information is required to confirm your spouse’s eligibility and enrollment in their employer’s health plan. Employee and Spouse …PEBTF Health Advocate is offered free of charge to members (employees, retirees, spouses/domestic partners and dependent children). PEBTF Health Advocate offers high-touch personalized support to help you navigate a complicated health care system. The service provides you and your family with confidential, one-on-one help. Schuylkill County. Aetna Medicare SM Plan (PPO) CBC Blue Journey Medicare HMO. Geisinger Gold Classic (HMO) REHP Prescription Drug Coverage. P-EBT helps families cover the cost of food for school-age children Non-preferred brand-name drug: $120, plus the cost difference between the brand and the generic, if one exists. Retail Maintenance at a Rite Aid Pharmacy (up to 90-day supply) - Generic drug: $30; Preferred brand-name drug: $80, plus the cost difference between the brand and the generic, if one exists.; Non-preferred brand-name drug: $160, plus ... Jun 14, 2019 ... On February 15, 2019, we published “NEW POLICIES & PROCEDURES FOR PEBTF MEDICAL BENEFIT. SPECIALTY MEDICATION COVERAGE.pebtf The CVS Caremark ® Performance Drug List - Standard Control for PEBTF is a guide within select therapeutic categories for clients, plan members and health care providers.PEBTF The CVS Caremark® Performance Drug List - Standard Control for PEBTF is a guide within select therapeutic categories for clients, plan members and health care providers. Generics should be considered the first line of prescribing. If there is no generic available, there may be more than one brand-name medicine to treat a condition.Business Wire. The Board of Trustees of the Pennsylvania Employees Benefit Trust Fund (PEBTF) today announced the appointment of Kathryn M. Farley to the position of …The fast and easy way to access benefits - anytime and anywhere. COMPASS is an online tool for Pennsylvanians to apply for many health and human service programs and manage benefit information. Click on the Apply Now button below to begin. APPLY NOW.Services or supplies provided by a Hospital or Other Facility Provider, or by a Physician or Other Professional Provider that the Claims Payor - PPO, HMO, or Mental Health and Substance Abuse Plan Provider, or the PEBTF - determines are: (a) appropriate for the symptoms and diagnosis or treatment of the Member's condition, Illness, disease, or ...120 days prior to the month you turn 65: You will receive a packet of information from the PEBTF via certified mail. You must enroll in both Medicare Part A and Medicare Part B to continue medical and prescription drug coverage under the Retired Employees Health Program (REHP). Contact the Social Security Administration at 1-800-772-1213 three ...Mail Order and CVS Pharmacy – up to a 90 Day Supply. Your Copayment. Tier 1: Generic drug. $22.50. Tier 2: Preferred brand-name drug. $60, plus the cost difference between the brand and the generic, if one exists. Tier 3: Non-Preferred brand-name drug. $120, plus the cost difference between the brand and the generic, if one exists.PEBTF 2023 Open Enrollment Webinar for Non-Medicare Retired Members ...The Pennsylvania Employees Benefit Trust Fund (PEBTF) is seeking an exceptional leader for the coveted role of Executive Director.The survivor spouse should contact the State Employees’ Retirement System (SERS), at 1-800-633-5461 (if the retiree has a pension through SERS). All others should contact the PEBTF at 1-800-522-7279. After contacting SERS or the PEBTF, the PEBTF will send a letter that explains how the spouse can enroll in survivor spouse benefits.With the federal public health emergency ending in May 2023, P-EBT services are no longer being offered.Your physician should be the only one prescribing medications for you. If you should happen to receive a call similar to what was reported above, please contact the PEBTF’s Fraud area via the Contact the PEBTF section of www.pebtf.org or call the PEBTF at 1-800-522-7279.PEBTF - Log In. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison. The weight management program is a covered preventive benefit for PEBTF employees and dependents over 18 years old with an Aetna health plan, who qualify through the health quiz. How do I sign up?Appointments are available the last Thursday of each month (except on holidays). Please call the PEBTF to schedule. Appointments must be scheduled in advance. Unscheduled walk-ins are not accepted. Secure Dropbox: For your convenience a locked drop-box is located just inside the main doors of the PEBTF offices. You may drop off a check payment ... For more information about Aetna plans, go to PEBTF.AetnaMedicare.com or call Member Services at toll-free at 1-888-272-5651 (TTY: 711). Hours are 8 a.m. to 9 p.m. EST, Monday through Friday. The provider network may change at any time. You will receive notice when necessary. In case of emergency, you should call 911 or the local emergency hotline. Jul 1, 2012 ... PEBTF and REHP Members. Below is a list of medicines by drug class that will not be covered without a prior authorization. If you continue ...PEBTF-6 Disabled Dependent Certification Form. PEBTF-11 Retiree Declaration of Spouse Health Coverage for Retiree Members. PEBTF-14 Adult Dependent Coverage Form. PEBTF-36 Retiree Employer Benefit Verification Form for Retiree Members. PEBTF-40 Direct Payment Authorization Form.About Us. The Pennsylvania Employees Benefit Trust Fund (PEBTF), established in 1988, administers health care benefits to approximately 68,000 eligible Commonwealth of Pennsylvania employees and their dependents and 65,000 retirees and their dependents, as well as additional employer groups. The PEBTF is governed by a Board of Trustees ... PEBTF-11 Retiree Declaration of Spouse Health Coverage for Retiree Members. PEBTF-14 Adult Dependent Coverage Form. PEBTF-36 Active Employer Benefit Verification Form for Active Members. PEBTF-36 Retiree Employer Benefit Verification Form for Retiree Members. PEBTF-40 Direct Payment Authorization Form.PEBTF-14 Adult Dependent Coverage Form. PEBTF-36 Active Employer Benefit Verification Form for Active Members. PEBTF-40 Direct Payment Authorization Form. PEBTF-41 Enrollment in PEBTF Prescription Drug Plan Without PEBTF Medical Plan Coverage. PEBTF-44 Attesting to Other Coverage Due to a Plan Change Effective 4/1/2021 …The Summary of Benefits & Coverage (SBC) is an easy to understand summary of your benefits and coverage under each plan option – PPO, HMO and Bronze Plan. It is meant as a summary only. For more detailed benefit information, see the PEBTF Summary Plan Description (SPD). Bronze Plan (for employees working an average of 30 hours per week ... Open Enrollment: Enrollment Instructions for Active Members. Visit the Open Enrollment section of this website for more information on your health plan choices. If you have questions about your medical plan options, coverage for services, etc. please contact the PEBTF at 1-800-522-7279. When you are ready to select a medical plan, you …PEBTF - Open Enrollment. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison.Jul 1, 2012 ... PEBTF and REHP Members. Below is a list of medicines by drug class that will not be covered without a prior authorization. If you continue ...* For more information about limitations and exceptions, see the SPD or plan document at www.pebtf.org. Page 4 of 6 Common Medical Event Services You May Need What You Will Pay Limitations, Exceptions, & Other Important Information Network Provider (You will pay the least) Out-of-Network Provider (You will pay the most) Habilitation services PEBTF for secondary coverage only. Any claims must be submitted to your spouse’s employer-sponsored health plan before they can be submitted for consideration of payment through the PEBTF health plans. The following information is required to confirm your spouse’s eligibility and enrollment in their employer’s health plan. Employee and Spouse …The PEBTF will provide new employees/enrollments with information on how to participate in the Get Healthy Program and a due date after your health plan enrollment has been processed. New enrollments who qualify for the Get Healthy waiver will have the waiver applied retroactive to their first day of enrollment.Make these fast steps to change the PDF Pebtf forms 36 online free of charge: ... pebtf spouse attestation form pebtf form 11 pebtf 2 form pebtf physician ...New users, enter registration key, PEBTF. Any questions or issues with online registration may be directed to Quest Diagnostics Customer Support by email at [email protected] or by calling 1-844-598-7966, Monday – Friday, 8 a.m. – 8 p.m. EST and Saturday 8:30 a.m. – 3 p.m. EST. ...Mounjaro Prior Authorization Process Tips Indication and Select Safety Information Indication: Mounjaro is indicated as an adjunct to diet and exercise to improve glycemic control in adults with type 2 diabetes mellitus. Limitations of Use: Mounjaro has not been studied in patients with a history of pancreatitis.Mounjaro isThe weight management program is a covered preventive benefit for PEBTF employees and dependents over 18 years old with an Aetna health plan, who qualify through the health quiz. How do I sign up?The Summary of Benefits & Coverage (SBC) is an easy to understand summary of your benefits and coverage under each plan option – PPO, HMO and Bronze Plan. It is meant as a summary only. For more detailed benefit information, see the PEBTF Summary Plan Description (SPD). Bronze Plan (for employees working an average of 30 hours per week ...Summary. In-network deductibles differ between the Choice PPO and the Basic PPO: ­ - Choice PPO – Annual in-network deductible is $400 single/$800 family. ­ - Basic PPO – Annual in-network deductible is $1,500 single/$3,000 family. PPO option covers medical services as set forth in the PEBTF Plan Document. PPO option offers both an in ... The PEBTF will not receive any information that would enable us to identify you or your individual results. Who is eligible to complete the wellness screening? For 2021, wellness screenings are available to employees only who are enrolled in PEBTF medical and/or prescription drug benefits.Jul 1, 2012 ... PEBTF and REHP Members. Below is a list of medicines by drug class that will not be covered without a prior authorization. If you continue ...PEBTF - Log In. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison. The official Maryland EBT/P-EBT customer service phone line is 1-800-997-2222. This is the only number that should be used for inquiries related to your card. The customer service call center can be reached 24 hours a day, 7 days to order a new card, inquire about your balance or change your Personal Identification Number (PIN).Enter your last name, date of birth and social security number. On the next screen, you will be able to Select your Payment – either pay in full or make a custom payment. Enter the card holder name, credit card number, expiration date and security code and click on Proceed to Checkout. Click on Complete Payment. It is designed to help you, through online tools, a printed workbook and toll-free access to expert Quit Coaches®, to make good decisions about nicotine replacement therapy, develop new thinking skills and learn how to act differently in situations that used to involve tobacco. Call 1-866-QUIT-4-LIFE (1-866-784-8454) today or visit www.quitnow ...The Summary of Benefits & Coverage (SBC) is an easy to understand summary of your benefits and coverage under each plan option – PPO, HMO and Bronze Plan. It is meant as a summary only. For more detailed benefit information, see the PEBTF Summary Plan Description (SPD). Bronze Plan (for employees working an average of 30 hours per week ... Custom HMOs cover medical services as set forth in the PEBTF Plan Document. Treatment for medical services must be coordinated by a Primary Care Physician (PCP) $5 copayment for PCP office visits (for general practitioners, family practitioners, internists and pediatricians) $150 copayment for emergency room visit (waived if the visit leads to ... Please note: This PEBTF Specialty Pharmacy Drug List is a list of drugs that must be filled through the pharmacy benefit plan, unless noted under the drug class heading. Prospective Patients: Ready to get started? Enroll to get your medications from CVS Specialty.Apr 1, 2014 ... The PEBTF also provides mental health and substance abuse coverage, as well as prescription drug, vision, dental and hearing aid benefits for ...PEBTF Specialty Preferred Drug Step Therapy List As part of the Specialty Guideline Management program, your doctor needs to request prior authorization for specialty drugs before they will be covered by your prescription benefits. The …The Pennsylvania Employees Benefit Trust Fund (PEBTF) holds a spouse attestation each year. The annual Spouse Attestation is for the following: Active employee hired on or after August 1, 2003, who has a spouse enrolled in PEBTF benefits Retiree, who as an active employee, was hired on or after August 1, 2003, who has aEach eligible child will receive a one-time payment of $120. DES will begin processing the school-aged children for their Summer P-EBT benefits starting August 7, 2023. Learn more about Summer P-EBT Benefits. P-EBT is established in the Families First Coronavirus Response Act (P.L. 116-127) as amended by the Consolidated Appropriations Act ...Pennsylvania Employees Benefit Trust Fund (PEBTF) 150 S. 43rd Street, Suite 1 Harrisburg, PA 17111-5700 Phone: 717-561-4750 800-522-7279 www.pebtf.org . 1 To all Eligible Retirees: The Commonwealth of Pennsylvania provides Retirees and eligible Dependent(s) with financial protection in the case of illness or injury. The …PEBTF Website Visit www.pebtf.org > 2023 Open Enrollment. View the webinar, plan benefits and compare plans in your county of residence. The Summaries of Benefits & Coverage are also available on the website. Contact the PEBTF g. Contact PEBTF Health Advocate Call 1-855-855-4238 to help locate network health care providers. Contact the HR ... PEBTF - Log In. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison. PEBTF 2023 Open Enrollment Webinar for Non-Medicare Retired Members ...Preventive Benefits: The Plan covers the following preventive services: Fecal occult blood test or fecal immunochemical test - every 12 months. Sigmoidoscopy (or screening barium enema as an alternative) - every 48 months. Screening colonoscopy every 10 years (not within 48 months of a screening sigmoidoscopy) - No minimum or maximum age ...Join to see who you already know at Pennsylvania Employees Benefit Join now Sign inIMPORTANT: If you intentionally provide false or misleading information about eligibility for coverage under the REHP Plan (or about a claim) or you fail to make a required contribution on time, your coverage may be terminated retroactively. This may occur, for example, if you file a false claim, fail to notify us promptly of a divorce or fail ...Benefit Cost Estimator Tool. You can find out what you will pay for certain medical services and procedures by visiting your health plan’s website. This self-service tool will help you estimate your out-of-pocket costs and compare costs for covered network and out-of-network services. This cost share will include any deductibles and copays.Mail Order and CVS Pharmacy – up to a 90 Day Supply. Your Copayment. Tier 1: Generic drug. $22.50. Tier 2: Preferred brand-name drug. $60, plus the cost difference between the brand and the generic, if one exists. Tier 3: Non-Preferred brand-name drug. $120, plus the cost difference between the brand and the generic, if one exists.After the PEBTF receives proper notice of a qualifying event it will send you or your family member(s) an election notice explaining your rights and applicable premium rates for coverage. You have 60 days from the date of the election notice to notify the PEBTF that you wish to elect COBRA continuation coverage. A separatePEBTF: Basic PPO Coverage for: Individual + Family | Plan Type: PPO The Summary of Benefits and Coverage (SBC) document will help you choose a health plan. The SBC shows you how you and the plan would share the cost for covered health care services. NOTE: Information about the cost of this plan (called the premium) will be providedThe Summary of Benefits & Coverage (SBC) is an easy to understand summary of your benefits and coverage under each plan option – PPO, HMO and Bronze Plan. It is meant as a summary only. For more detailed benefit information, see the PEBTF Summary Plan Description (SPD). Bronze Plan (for employees working an average of 30 hours per week ... 120 days prior to the month you turn 65: You will receive a packet of information from the PEBTF via certified mail. You must enroll in both Medicare Part A and Medicare Part B to continue medical and prescription drug coverage under the Retired Employees Health Program (REHP). Contact the Social Security Administration at 1-800-772-1213 three ...Wellness Discounts Offered by PEBTF Medical Plans. As part of your enrollment in a medical plan option, you have access to discounts to: Health clubs and gyms. Diet programs. Complementary health and alternative medicine. Discounts vary by medical plan. Acronym, Definition. PEBTF, Pennsylvania Employees Benefit Trust Fund. Copyright 1988-2018 AcronymFinder.com, All rights reserved. Suggest new definition.Enter your last name, date of birth and social security number. On the next screen, you will be able to Select your Payment – either pay in full or make a custom payment. Enter the card holder name, credit card number, expiration date and security code and click on Proceed to Checkout. Click on Complete Payment. These cookies allow us to count visits and traffic sources so we can measure and improve the performance of our site. They help us to know which pages are the most and least popular and see how visitors move around the site.deferred contribution debt to the PEBTF and that the PEBTF Trustees take action against the. Commonwealth to collect the deferred contributions. The Motion ...The PEBTF includes the Prior Authorization List on this Web site under Publications and Forms. You may also contact the PEBTF or the prescription drug plan to determine if a drug appears on the Prior Authorization List. Otherwise, you will be told that the drug appears on the list when you try to fill the prescription at the pharmacy.assistance, contact: Your medical plan (telephone number appears on your ID card) or the PEBTF at 1-800-522-7279 for instructions. Does this plan provide Minimum Essential Coverage? Yes Minimum Essential Coverage generally includes plans, health insurance available through the Marketplace or other individual market policies, Medicare, Medicaid, Open Enrollment: Enrollment Instructions for Active Members. Visit the Open Enrollment section of this website for more information on your health plan choices. If you have questions about your medical plan options, coverage for services, etc. please contact the PEBTF at 1-800-522-7279. When you are ready to select a medical plan, you …You will work virtually with a physical therapist to design a home exercise program to fit into your busy schedule. Most exercise sessions take as little as 15 minutes to complete. Your program will combine gentle exercise with one-on-one support to improve your condition, reduce your pain and help you move with confidence.* For more information about limitations and exceptions, see the SPD or plan document at www.pebtf.org. Page 3 of 6 Common Medical Event Services You May Need What You Will Pay Limitations, Exceptions, & Other Network Provider Important Information (You will pay the least) Out-of-Network Provider (You will pay the most) If you have outpatientPennsylvania State Employees Retirement System. By clicking on the links provided, you are being redirected. Empower Retirement, its parent company and/or any of its subsidiaries are not responsible for the content provided and/or updates with respect to the materialCore securities, when offered, are offered through GWFS Equities, Inc. and/or ...Wellness Discounts Offered by PEBTF Medical Plans. As part of your enrollment in a medical plan option, you have access to discounts to: Health clubs and gyms. Diet programs. Complementary health and alternative medicine. Discounts vary by medical plan. REHP Benefit Videos. The following videos provide information on a variety of topics pertaining to retiree benefits. Eligibility.IMPORTANT: If you intentionally provide false or misleading information about eligibility for coverage under the REHP Plan (or about a claim) or you fail to make a required contribution on time, your coverage may be terminated retroactively. This may occur, for example, if you file a false claim, fail to notify us promptly of a divorce or fail ...PEBTF Specialty Preferred Drug Step Therapy List As part of the Specialty Guideline Management program, your doctor needs to request prior authorization for specialty drugs before they will be covered by your prescription benefits. The …IMPORTANT: If you intentionally provide false or misleading information about eligibility for coverage under the REHP Plan (or about a claim) or you fail to make a required contribution on time, your coverage may be terminated retroactively. This may occur, for example, if you file a false claim, fail to notify us promptly of a divorce or fail ... Access – PA Medicaid (must have medical insurance); Aetna (except PEBTF plans); AmeriHealth; AmeriHealth Administrators; Blue Cross Blue Shield; Cigna ...Services or supplies provided by a Hospital or Other Facility Provider, or by a Physician or Other Professional Provider that the Claims Payor - PPO, HMO, or Mental Health and Substance Abuse Plan Provider, or the PEBTF - determines are: (a) appropriate for the symptoms and diagnosis or treatment of the Member's condition, Illness, disease, or ...

PEBTF - Open Enrollment. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison.. Total wine fresno

pebtf

The following details the Copayments under the Prescription Drug Plan. Prescriptions at a Network Pharmacy – up to a 30 Day Supply. Your Copayment. Tier 1: Generic drug. $12. Tier 2: Preferred brand-name drug. $30, plus the cost difference between the brand and the generic, if one exists. Tier 3: Non-Preferred brand-name drug.Jan 1, 2013 · Medicare Part D Prescription Drug Plan. Three-Tier Copayment Plan - Generic, Preferred Drugs and Non-Preferred Drugs. Retail Prescriptions (up to 30-day supply) - Generic drug: $12; Preferred brand-name drug: $30, plus the cost difference between the brand and the generic, if one exists; Non-preferred brand-name drug: $60, plus the cost ... The employee regularly interacts with annuitants, dependents, survivor spouses, employers, SERS' personnel, the OA, and the PEBTF to provide information, ...Finding a doctor is easier than ever How to Find In-Network Doctors Go to your member website at Select the Find a Doctor or Rx tab. Choose the Find a Doctor, Hospital, or Other Medical Provider link. Select the Pick a Plan link. • Enter (from your ID Card).You must be an authorized representative to create a member account or reset an Email/Password. By using or accessing PEBTF.org (the 'Website'), you agree that you will use it for legitimate purposes only, and not for any illegal or unauthorized purpose, including without limitation, in violation of any intellectual property or privacy law. Retired members can get duplicate tax forms and click through to the Pennsylvania Employees Benefit Trust Fund - the PEBTF - for more about your health care. Online Calculators. Estimate your future retirement benefit or the federal tax withholding from your current pension payments. Sign Up for News. Provide your e-mail address to get …The PEBTF Drug List is a guide within select therapeutic categories for clients, plan members and health care providers. Generics should be considered the first line of prescribing. If there is no generic available, there may be more than one brand-name medicine to treat a condition.PEBTF (Pennsylvania Employees Benefit Trust Fund) Lab testing: If you have a PEBTF plan, the COVID -19 diagnostic test is covered without copays and deductibles. The …A: If such an unfortunate event should occur, Active members should contact the HR Service Center or their local HR Office if their agency is not serviced by the HR Service Center. Retiree members may contact the State Employees' Retirement System (SERS) at 800-633-5461. Once you provide the necessary documentation, this information will be ... PEBTF - Benefit Comparison. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison.Open Enrollment: Enrollment Instructions for Active Members. Visit the Open Enrollment section of this website for more information on your health plan choices. If you have questions about your medical plan options, coverage for services, etc. please contact the PEBTF at 1-800-522-7279. When you are ready to select a medical plan, you …The Bronze Plan is offered to non-permanent employees working an average of 30 hours a week. It offers both an in-network and an out-of-network benefit. You are responsible for the first $9,450 of in-network covered medical and prescription drug expenses for single coverage or $18,900 for family coverage. This is known as the annual deductible.The PEBTF will not receive any information that would enable us to identify you or your individual results. Who is eligible to complete the wellness screening? For 2022, wellness screenings are available to employees only who are enrolled in PEBTF medical and/or prescription drug benefits.120 days prior to the month you turn 65: You will receive a packet of information from the PEBTF via certified mail. You must enroll in both Medicare Part A and Medicare Part B to continue medical and prescription drug coverage under the Retired Employees Health Program (REHP). Contact the Social Security Administration at 1-800-772-1213 three ...PEBTFSummary. In-network deductibles differ between the Choice PPO and the Basic PPO. – Choice PPO – Annual in-network deductible is $400 single/$800 family. – Basic PPO – Annual in-network deductible is $1,500 single/$3,000 family. PPO option covers medical services as set forth in the PEBTF Plan Document. PPO option offers both an in ... SilverScript. Evidence of Coverage Evidence of Coverage January 1, 2024, and December 31, 2024..

Popular Topics