PEBTF Open Enrollment

GETTING STARTED CHECKLIST

Did you do your homework?

I read the PEBTF open enrollment newsletter.

I reviewed the information on the PEBTF website and Employee Self Service.

I watched a recorded webinar online.

Did you check the networks?

I have my (and my dependents) list of doctors and hospitals that we will use in 2018.

I reviewed the links to the health plan networks and confirmed that my doctors and hospitals are in

the network.

o I have the lowest out-of-pocket costs if I use providers that are in the plan’s network. If I use

providers outside of the plan network, I will be responsible for all or a portion of the costs. I

understand that there is no out-of-network benefit under the PEBTF Custom HMO.

o The PPO plan networks include providers throughout Pennsylvania and the United States. The

HMO networks are narrower and limited to specific regions of the state. I understand that this is

important if I have dependents who live in another part of PA or in another state.

o The PPO plan allows me to see a specialist without a referral. Under the HMO, I must get a

referral from my primary care physician (PCP) for all services.

Have you anticipated your needs?

I understand that the PEBTF Custom HMO has lower copayments for primary care physician and

specialist than the PPOs.

I have considered the number of regular appointments I have with my health care providers.

I have considered whether I will need medical services that are subject to a deductible. The Choice

PPO has a lower deductible than the Basic PPO. The PEBTF Custom HMO has no deductible.

I have compared costs across plans and understand when the deductible does/does not apply. For

more information on the deductible, check out this fact sheet.

Have you considered the impact on your pay?

I was hired on or after August 1, 2003.

o If enrolled in benefits and participating in Get Healthy, I will have 2.25% of my biweekly pay

deducted from my pay check (2.25%, plus $63.62 if not participating in Get Healthy).

o If I elect the Choice PPO, I will have an additional biweekly deduction (plan buy-up) of $8.85 for

single coverage or $23.08 for family coverage.

o If I elect the Basic PPO or PEBTF Custom HMO, I will pay only the 2.25% (if participating in Get

Healthy) or the 2.25% plus $63.62 (if not participating in Get Healthy).

I was hired before August 1, 2003.

o I can enroll in the Choice PPO, Basic PPO, or PEBTF Custom HMO and, if participating in Get

Healthy, I will have 2.25% of my biweekly pay deducted from my pay check (2.25%, plus $63.62

if not participating in Get Healthy).

o I understand that there are no additional payroll deductions, regardless of the plan that I select.