Pebtf - 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 2023, wellness screenings are available to employees only who are enrolled in PEBTF medical and/or prescription drug benefits.

 
The Summary Plan Description (SPD) summarizes the main terms of the benefits provided to Members and their eligible Dependents under the Pennsylvania Employees Benefit Trust Fund Plan. This SPD replaces all previous Summary Plan Descriptions for the Plan. The SPD has been prepared to help you understand the main features of the health benefit .... Osu calendar

Highmark Blue Shield 1-888-301-9273 PEBTF Active Members 2024 • In Network Providers agree to accept the PPO Plan Allowance as payment in full, often less than their normal charge. If you visit an out of network provider, you are responsible for paying the Deductible,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. Effective July 1, 2014, the PEBTF provides coverage for the following preventive care benefits under all of its medical plans at 100% for in network preventive care. This chart outlines the preventive care benefits for adults, women, including pregnant women, and children. USPSTF: Evidence-based items or services that have in effect a rating of ... 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 …Retail Prescriptions (up to 30-day supply) - Generic drug: $15; Preferred brand-name drug: $40, plus the cost difference between the brand and the generic, if one exists.; Non-preferred brand-name drug: $80, plus the cost difference between the brand and the generic, if one exists. Retail Maintainence at CVS Pharmacy and Mail Order - Generic ... 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. We advise you to remain enrolled in the REHP medical and prescription drug plan coverage. If you want to opt out of the new plan, you will need to do so by November 10, 2023. Just call the PEBTF at 1-800-522-7279, 8 a.m. to 5 p.m. Keep in mind: If you opt out, you and any covered dependents will be terminated from REHP medical and prescription ...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 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 ... 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 …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 ...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.New users, enter registration key, PEBTF. Any questions or issues with online registration may be directed to Quest Diagnostics Customer Support 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.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 ... Call 1-800-522-7279 or email [email protected]. Contact PEBTF Health Advocate. Contact the HR Service Center (or your local HR office if your agency is not supported by the HR Service Center) Call 1-855-855-4238 to help locate network health care providers. Visit Employee Self Service at www.myworkplace.pa.gov to complete your enrollment.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 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 …With the federal public health emergency ending in May 2023, P-EBT services are no longer being offered.COVID-19 test (processed at a pharmacy, doctor’s office or other location) Copay applies. Over the counter COVID-19 test kits. Covered 4 per member per month under your SilverScript prescription drug plan; maximum reimbursement of $12 per test kit if claim form is submitted to CVS Caremark. To purchase an at-home COVID test: Present your ...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 ...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. * 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 outpatientEnter 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. 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. 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 2023 Open Enrollment Webinar for Non-Medicare Retired Members ...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. ...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 ...Enter your username and password in the Sign In box. You will see your demographic information populate. If you receive the message, Last 4 SSN is required, click on My Account in the upper right, and hit Save. That should take you directly to the Welcome screen where you can click on Get Started to register for a wellness screening.Apr 3, 2023 ... PEBTF is also run quarterly for all CHIP enrollees. PEBTF is not verified upon receipt, caseworker must verify PEBTF eligibility. PACSES. No ...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.Visit www.pebtf.org > 2023 Open Enrollment. View the webinar, plan benefits and compare plans in your county of residence. Call 1-800-522-7279 or email [email protected]. The representative can answer questions about your benefits, costs and how to change plans. Call 1-855-855-4238 to help locate network doctors. PEBTF Website Contact ...Visit www.pebtf.org> Get Healthy > Help for Diabetics for more information and a direct link to the Livongo website to get started. Or call Livongo Member Support at 1-800-945-4355 and mention registration code, PEBTF. *To enroll in Livongo, you must be enrolled in a PEBTF medical and/or prescription drug plan. You must also meet thePEBTF-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.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 …contact the Pennsylvania Employees' Benefit Trust Fund (PEBTF} at (717) 561-. 4750 or toll-free at (800) 522-7279, or at www.pebtf.org. Benefits, benefit ...Generic drugs (Tier 1) $15 copay/prescription up to 30 days; $22.50. copay/prescription up to 90 days (CVS & mail order) Submit claim form. Covers up to a 30-day supply (retail prescription); 31-90 day supply (mail order prescription and CVS/pharmacy).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 ...The Summary Plan Description (SPD) summarizes the main terms of the benefits provided to Members and their eligible Dependents under the Pennsylvania Employees Benefit Trust Fund Plan. This SPD replaces all previous Summary Plan Descriptions for the Plan. The SPD has been prepared to help you understand the main features of the health benefit ...Radiation therapy, chemotherapy, kidney dialysis. Home Health Care (60 visits in 90 days) Hospice. Skilled Nursing Facility (180 days per calendar year) Covered 100%. Geisinger Health Plan. 1-800-504-0443. PEBTF Active Members 2022. 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. Call 1-800-522-7279 or email [email protected]. Contact PEBTF Health Advocate. Contact the HR Service Center (or your local HR office if your agency is not supported by the HR Service Center) Call 1-855-855-4238 to help locate network health care providers. Visit Employee Self Service at www.myworkplace.pa.gov to complete your enrollment.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?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 ... 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 ... Mar 1, 2018 ... What are your initial thoughts on the Pennsylvania Employees Benefit Trust Fund (PEBTF)'s decision to cover bariatric surgery for state ...SilverScript. Evidence of Coverage Evidence of Coverage January 1, 2024, and December 31, 2024.Pennsylvania Employees Benefit Trust Fund (PEBTF)—The PEBTF administers health care benefits for approximately 76,000 eligible commonwealth employees and their …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 …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 Generic drugs (Tier 1) $15 copay/prescription up to 30 days; $22.50. copay/prescription up to 90 days (CVS & mail order) Submit claim form. Covers up to a 30-day supply (retail prescription); 31-90 day supply (mail order prescription and CVS/pharmacy).2024 Formulary. SilverScript Employer PDP sponsored by REHP (SilverScript) 2024 Formulary. (List of Covered Drugs) PLEASE READ: THIS DOCUMENT CONTAINS INFORMATION ABOUT THE DRUGS WE COVER IN THIS PLAN. This formulary was updated on 08/16/2023. For more recent information or other questions, please contact …The PEBTF’s medical plans now offer free DPPs to members who are identified as having prediabetes or score as high risk for developing type 2 diabetes. A DPP is a year-long program consisting of 16 weekly lessons, followed …Join to see who you already know at Pennsylvania Employees Benefit Join now Sign inPEBTF - Benefit Comparison. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison. 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. ...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 ... Verify your membership. Please enter the last name, social security number, and birth date of the member's account that you would like to make a payment for and click Next.When you enroll in an Aetna ® Medicare plan, here's what you can expect. We'll mail you: A new member Journey Handbook with helpful tools, cost-saving resources and important tips. Read your plan documents to learn more about your plan and how it works. The Evidence of Coverage will tell you exactly what's covered and your out-of-pocket costs. 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).Visit www.pebtf.org> Get Healthy > Help for Diabetics for more information and a direct link to the Livongo website to get started. Or call Livongo Member Support at 1-800-945-4355 and mention registration code, PEBTF. *To enroll in Livongo, you must be enrolled in a PEBTF medical and/or prescription drug plan. You must also meet thePEBTF Custom HMO – Aetna (SOB). PEBTF Custom HMO – Geisinger (SOB). Resources & Contacts: Pennsylvania Employees Benefit Trust Fund. Phone: 717-561-4750 (ext ...If you have any questions, please contact a PEBTF Benefit Services Representative at 1-800-522-7279. 3. Pennsylvania Employees Benefit Trust Fund 150 South 43rd Street, Suite 1 Harrisburg, PA 17111-5700. Local: 717-561-4750 Toll Free: 800-522-7279. PEBTF telephone hours: 8 a.m. – 5 p.m. Monday through Friday.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. Join to see who you already know at Pennsylvania Employees Benefit Join now Sign inPEBTF 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 ... PEBTF-eligible employees can extend their health benefits to domestic partners and their dependents. The plan of benefits includes medical, prescription drug, dental, vision and hearing aid. Those who cover domestic partners will be charged the same rates and have the same plan choices as those in place for spousal and dependent coverage To ApplyPEBTF - Benefit Comparison. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison. 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 …The PEBTF’s medical plans now offer free DPPs to members who are identified as having prediabetes or score as high risk for developing type 2 diabetes. A DPP is a year-long program consisting of 16 weekly lessons, followed …Find out what works well at PEBTF from the people who know best. Get the inside scoop on jobs, salaries, top office locations, and CEO insights.Active Choice PPO Aetna Member Services 1-800-991-9222 PEBTF Active Members 2021 Proprietary We’re just a phone call away Member Services – 1-800-991-9222, 8 a.m. to 6 p.m. Monday through Friday When you need help or information, Aetna Member Services is just a toll-free call away.PEBTF-eligible employees can extend their health benefits to domestic partners and their dependents. The plan of benefits includes medical, prescription drug, dental, vision and hearing aid. Those who cover domestic partners will be charged the same rates and have the same plan choices as those in place for spousal and dependent coverage To ApplySummary. 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 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.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 2023, wellness screenings are available to employees only who are enrolled in PEBTF medical and/or prescription drug benefits.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. Jan 1, 2022 ... PEBTF's durable medical equipment (DME) coverage transitioned from DMEnsions to Aetna®. As of January 1, 2022, Aetna provides DME coverage for ...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. PEBTF - Benefit Comparison. Active Members. Benefit Information. Health Plan Choices by County. Open Enrollment Information. Benefit Comparison.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 Specialty Pharmacy Drug List Providing one of the broadest offerings of specialty pharmaceuticals in the industry The Specialty Pharmacy Drug List is a guide of medications available through CVS Specialty®. Our goal is to help make your life better. With more than 40 years of experience, CVS Specialty provides quality care and service.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. 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. 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 ... 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 ...Teladoc and telemedicine visits with your Behavioral Health doctor. $0 copay under the Optum Mental Health & Substance Use benefit. COVID-19 test (processed at a pharmacy, doctor’s office or other location) Copay applies. PPO: $0 if at a Quest Diagnostics or LabCorp; subject to your deductible elsewhere. Over the counter COVID-19 test kits.The PEBTF complies with applicable Federal civil rights laws and does not discriminate on the basis of race, color, national origin, age, disability or sex. ATENCIÓN: si habla español, tiene a su disposición servicios gratuitos de asistencia …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 ...

(PEBTF) operates as a non-profit organization. The Organization offers health care assistance such as vision, dental, hearing aid, and other related .... Porcelain corsets

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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.Jun 17, 2010 ... Harrisburg – The Pennsylvania Employees Benefit Trust Fund (PEBTF) announced today that Highmark, Aetna, Capital Blue Cross, ...Call 1-800-522-7279 or email [email protected]. Contact PEBTF Health Advocate. Contact the HR Service Center (or your local HR office if your agency is not supported by the HR Service Center) Call 1-855-855-4238 to help locate network health care providers. Visit Employee Self Service at www.myworkplace.pa.gov to complete your enrollment.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 ...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.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 Summary Plan Description (SPD) summarizes the main terms of the benefits provided to Members and their eligible Dependents under the Pennsylvania Employees Benefit Trust Fund Plan. This SPD replaces all previous Summary Plan Descriptions for the Plan. The SPD has been prepared to help you understand the main features of the health benefit ...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).Acronym, Definition. PEBTF, Pennsylvania Employees Benefit Trust Fund. Copyright 1988-2018 AcronymFinder.com, All rights reserved. Suggest new definition.The PEBTF also provides mental health and substance abuse coverage, as well as prescription drug, vision, dental and hearing aid benefits for eligible individuals. We are …Claim forms are available at a participating provider office. United Concordia also accepts any standard dental claim form. Your dentist will complete an examination and recommend needed treatment. For more information, refer to your Summary Plan Description or contact PEBTF. United Concordia Dental Options (UCCI) www.ucci.com 1-888-320-3321.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 …With the federal public health emergency ending in May 2023, P-EBT services are no longer being offered..

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