PEBTF Employees - AFSCME, SCUPA, SEIU, PDA

 

Medical and Supplemental Insurance

Newborn (natural child)

Newborns are automatically covered for 31 days after birth under your PEBTF health benefits. You must enroll your child within 60 days of birth for coverage to continue uninterrupted. The following documentation must be provided to your Human Resources office:

1. A completed PEBTF-2 Enrollment/Change Form AND;
2. Your child's original birth certificate with your name listed as the parent. (A representative from the Human Resources office must initial your enrollment form confirming they saw the document.)

Adoption

Coverage is provided for legally adopted children, including during the adoption probationary period. The following documentation must be provided to your Human Resources office:

1. A completed PEBTF-2 Enrollment/Change Form AND;
2. Letter of Intent to Adopt from the court or attorney AND;
3. Court Adoption papers (This can be provided once the adoption is finalized. If the adoption will not be finalized within the 6 month adoption probationary period, an explanation and anticipated date of finalization from the attorney or placement agency must be provided.)

Cost:
You may pay an additional biweekly cost to cover your dependent. 
If your most recent date of hire was:

Prior to August 1, 2003 - There is no additional cost to add dependents to your health benefits.

On/After August 1, 2003 - If you currently have single coverage and are enrolled in the Choice PPO, you will pay an additional biweekly cost to add dependents. Otherwise, your cost will not change.  Refer to the PEBTF Open Enrollment Newsletter for further details on cost.

 

Life and Accident Insurance

Voluntary Group Life and Accident Insurance (CIGNA):

Add Coverage -
If you are currently enrolled in Voluntary Life and Accident coverage you may add coverage for your child. Complete the enrollment form and return it to your Human Resources office within 31 days of your child's birth.

You may apply for voluntary life coverage or apply to increase your coverage at any time by submitting a completed enrollment form to your Human Resources office.  New enrollments and increases in coverage are subject to medical underwriting and approval by CIGNA.

Update your Beneficiary Election -
Log on to Employee Self-Service (ESS) and follow these instructions if you wish to update your CIGNA Voluntary Group Life and Accident Insurance beneficiary.

Employer-Paid Life Insurance (MetLife):

Update your Beneficiary Election -
Log on to MetLife wish you wish to update your employer-paid basic term life insurance beneficiary.

 

Flexible Spending Accounts (FSA)

Health Care FSA - To pay for your family's health care expenses not paid by insurance.
Dependent Care Assistance Program - To pay for child or elder care expenses, such as daycare or summer camp.

You may enroll or change the amount you contribute to your FSA plans by completing the enrollment form and returning it to your Human Resources office within 60 days of the event.

  

Payroll and Taxes

You may need to adjust your withholding for federal income taxes. This can be done any time by logging into Employee Self-Service (ESS) and following these instructions.
 

Group Retirement Plans

Consider whether you need to make any adjustments to your beneficiaries:

State Employee Retirement System (SERS) -
Complete an Active Member Beneficiary Nomination Form and return it to SERS at the address on the bottom of the first page of the form.

Alternative Retirement Plan (ARP) -
Log into your Fidelity or TIAA account to update your beneficiaries.

 

Voluntary Retirement Plans

Employees are eligible to enroll at any time. If you have an existing account, consider updating your beneficiaries.

Deferred Compensation 457 - Log into your Empower retirement account to update your beneficiaries.

Tax-Sheltered Annuity 403(b) - Log into your Fidelity or TIAA account to update your beneficiaries.

State Employee Assistance Program (SEAP)

Adding a child to your family is a joyful time in your life, but can also be a time of adjustment.  SEAP provides various resources that can help during this time including counseling, financial planning, and legal services.  SEAP services are available to everyone who lives in your house, as well as your parents, adult children, and siblings regardless of where they live.  You do not need to take any action to add family members to this plan, they are automatically covered.