Notices

Active Employees

Select the plan year to view the notices listed below:  2025 or 2024 or 2023

  • Uniform Summary of Benefits and Coverage (SBC)
  • Genetic Information Non-Discrimination Act of 2008
  • Medical Plan Opt Out of Certain Provisions of the Public Health Services (PHS) Act
  • Medicare Part D Notice of Creditable Coverage
  • PEBC Health Plans Notice, Medicaid and the Children's Health Insurance Program (CHIP)
  • Continuation of Group Coverage (COBRA) Initial Notice (Newly hired employees)
  • Employer Notice of Exchange
  • PEBC Privacy Notice
  • Patriot Act Notice and Important Health Savings Account Information
  • Notice Regarding the PEBC Wellness Program for the Americans with Disability Act (ADA)
  • Paperwork Reduction Act Statement


Notice of Privacy Practices


Retirees

Select the plan year to view the notices listed below: 2024 or 2023

  • Uniform Summary of Benefits and Coverage (SBC)
  • Genetic Information Non-Discrimination Act of 2008
  • Medical Plan Opt out of Certain Provisions of the Public Health Services (PHS) Act
  • Medicare Part D Notice of Creditable Coverage
  • PEBC Health Plans Notice, Medicaid and the Children’s Health Insurance Program (CHIP), Offer Free or Low-Cost Health Coverage to Children and Families 
  • PEBC Privacy Notice