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Pebtf 33 eligibility form

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The document is an Employer Benefit Verification Form for spouses or domestic partners of Commonwealth of Pennsylvania employees hired on or after August 1, 2003. It outlines the requirement that these individuals must enroll in their own employer's health insurance to be eligible for secondary coverage under the Pennsylvania Employees Benefit Trust Fund (PEBTF). The form collects necessary information from both the employee and their spouse/domestic partner's employer to verify eligibility and enrollment in health benefits.

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Versions	Form popularity	Fillable & printable
2023	4.3 Satisfied (33 Votes)
2022	4.8 Satisfied (36 Votes)
2019	4.2 Satisfied (57 Votes)
2016	4.6 Satisfied (36 Votes)
2015	4 Satisfied (58 Votes)

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What does pebtf stand for?

A verification of benefits (VOB) is a way to ensure the services that you render will result in payment from the insurance company. A VOB is important because it helps you to estimate what the patient owes and what the insurance might pay you.

What benefits do PA state employees get?

Commonwealth employees are eligible for a wide array of benefits, including medical and supplemental health benefits; the Dependent Care Account Program (DCAP); charitable giving through the State Employee Combined Appeal; voluntary life, dependent and long-term disability insurance; voluntary home and auto insurance,