Are you a new employee in 2009? Here's your enrollment packet.
This information describes the benefits available to you through the Public Employees Benefits Board (PEBB) Program. You must complete and return the appropriate forms to your personnel, payroll, or benefits office within 31 days of eligibility to receive coverage, or you will lose certain benefit rights.
If you have questions, contact your personnel, payroll, or benefits office.
Select the description that fits you:
For employees with medical and dental benefits:
2009 Employee Enrollment Guide (1.4 MB)
- Contact the plans
- Browse benefits
- Compare plan costs
- Find a plan in my county
Employee Enrollment/Change form (435.8 KB)- Covering family members on your account? Complete the appropriate forms:
Spouse or qualified domestic partner (447.9 KB)
Student over age 19 (234.3 KB)
Dependent with disabilities (311.4 KB)
Extended (legal) dependent (243.5 KB)
Medical Flexible Spending Account (FSA) -
Summary (97.6 KB)
Dependent Care Assistance Program (DCAP) -
Summary and Overview (65.4 KB)
Life insurance booklet (636.3 KB)
Life insurance enrollment form (139.5 KB)
Life insurance evidence of insurability form (97.8 KB)
Long term disability booklet (463.7 KB)
Long term disability enrollment/change form (109.3 KB)
Long term disability evidence of insurability form (101 KB)
Auto and home insurance (555.6 KB)
Long-term care insurance (144.1 KB)

