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Click ‘Get Form’ to open it in the editor.
Begin by entering your personal information in the 'Participant Information' section. Ensure that you print clearly, including your Social Security Number, Date of Birth, and contact details.
Select your Medicare Exchange option. Choose between options with or without PEBP Dental Coverage based on your eligibility.
If applicable, provide details for adding an eligible spouse or domestic partner. Include their Medicare A+B card and certified marriage or domestic partner certificate.
Complete the acknowledgment section by reading the statements carefully and signing where indicated. Make sure to date the form as well.
Review all entries for accuracy before submitting. Incomplete forms will be returned, so double-check each section.

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How does PEBP work with Medicare?

Yes, PEBP requires all retirees who are eligible for premium-free Medicare Part A to enroll in Part A coverage. PEBP also requires retirees to purchase Medicare Part B coverage at age 65 (or under age 65 if Medicare eligible due to a disability), regardless of whether a retiree qualifies for free Part A.

Do I still pay for Medicare if I have an Advantage plan?

Though Medicare covers most of your health care costs when youre 65 or older or have an eligible disability, confusing enrollment periods and decisions about which coverage works best for you can complicate the sign-up. Missing deadlines, delaying enrollment or choosing the wrong plan can cost you.

What is the biggest disadvantage of the Medicare Advantage plan?

The plan (rather than Medicare) decides how much you pay for the covered drugs, items, and services you get. The plan can only change what you pay once a year, on January 1. You still have to pay the Part B premium. Most people pay the standard Part B premium amount every month.

What are the biggest mistakes people make with Medicare?

While the compensation structure for Medicare agents can vary, most are paid based on a percentage of the premiums that their clients pay. This means that agents typically make more money when their clients enroll in more expensive plans.

What is PEBp insurance?

The Public Employees Benefits Program (PEBP) administers a group health and life insurance program which offers comprehensive medical, prescription drug, dental, vision and life insurance.

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Pebp state nv uswp-contentuploadsSTATE OF NEVADA PUBLIC EMPLOYEES BENEFITS PROGRAM 2026

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How does PEBP work with Medicare?

Do I still pay for Medicare if I have an Advantage plan?

What is the biggest disadvantage of the Medicare Advantage plan?

What are the biggest mistakes people make with Medicare?

What is PEBp insurance?

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Pebp state nv uswp-contentuploadsSTATE OF NEVADA PUBLIC EMPLOYEES BENEFITS PROGRAM 2026

Here's how it works

How to use or fill out pebp state nv uswp-contentuploadsSTATE OF NEVADA PUBLIC EMPLOYEES BENEFITS PROGRAM

See more pebp state nv uswp-contentuploadsSTATE OF NEVADA PUBLIC EMPLOYEES BENEFITS PROGRAM versions

Complete this form in 5 minutes or less

Got questions?

How does PEBP work with Medicare?

Do I still pay for Medicare if I have an Advantage plan?

What is the biggest disadvantage of the Medicare Advantage plan?

What are the biggest mistakes people make with Medicare?

What is PEBp insurance?

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