Public Employees' Benefit Board Summary Plan Description

Text Size: A+ A- A • Text Only

Public Employees' Benefit Board

DAS Divisions

Summary Plan Description

Summary Plan Description View or print the Summary Plan Description as a whole document or by section (all PDF).
	Download: Full Summary Plan Description Linked Table of Contents
	Section 1: Eligibility, Enrollment and Dates of Coverage Who is Eligible Individuals Eligible for Coverage Enrollment Periods and Effective Dates How to Enroll Midyear Plan Changes Individuals No Longer Eligible for Coverage
	Section 2: Medical Benefits Medical Plan Options Premium Rates Medical and Prescription Drug Plan Comparisons
	Section 3: Dental Benefits Dental Plan Options Premium Rates Dental Plan Comparison
	Section 4: Optional Benefits Life Insurance Short Term Disability Insurance Long Term Disability Insurance Accidental Death and Dismemberment Insurance Flexible Spending Accounts Long Term Care Insurance
	Section 5: Required Notices Plan Administration Benefit Fraud and Abuse Appeals Women's Health and Cancer Rights Your Prescription Drug Coverage and Medicare Special Enrollment Rights Medicaid and the Children's Health Insurance Program (CHIP) Continuation Coverage Rights Under COBRA Notice of Privacy Practices
	Appendix A: Midyear Plan Changes Appendix B: Health Improvement and Cost Containment Programs Chronology of Updates

Page updated: January 11, 2012