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Employer Benefit Verification Form - calu.edu

Employer Benefit Verification Form - calu.edu

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The Pennsylvania Employees Benefit Trust Fund (PEBTF) provides health benefits to Commonwealth of Pennsylvania employees and retirees. The below-referenced member is enrolled in PEBTF health benefits as a spouse/domestic partner of a commonwealth employee. For employees hired on or after 8/1/03, PEBTF eligibility rules require that the

  Trust, Pennsylvania, Employee, Benefits, Pennsylvania employees benefit trust, Alcu, Pennsylvania employees

Download Employer Benefit Verification Form - calu.edu

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