Pennsylvania Employees Benefit Trust Fund PEBTF

  • The Pennsylvania Employees Benefit Trust Fund (PEBTF) was formed in 1988 to administer health benefits of the employees of the Commonwealth of Pennsylvania. For IUP employees, the PEBTF administers health benefits for AFSCME, PDA, PSSU, and SCUPA employees.

    The PEBTF is not an insurance company. It is a tax-exempt, nonprofit trust fund which provides health and welfare benefits to eligible members and their eligible dependent(s) including medical, prescription drug, vision, dental, and hearing coverage. The level of benefits is determined by the Board of Trustees, seven of whom are designated by the Secretary of Administration of the Commonwealth of Pennsylvania and seven of whom are designated by participating unions in accordance with an Agreement and Declaration of Trust pursuant to which the PEBTF was established.

    A Board of Trustees, equally comprised of employer and union representatives, manages the PEBTF. The trustees meet regularly to review the operations of the PEBTF. The trustees establish PEBTF policies and determine any changes to benefits. The trustees are solely responsible for applying and interpreting the plan of health benefits, determining eligibility, and deciding all final level appeals.

    The day-to-day operations of the PEBTF are the responsibility of the executive director. Among other duties, the PEBTF’s staff maintains eligibility records, responds to inquiries from PEBTF members, and pays claims. The PEBTF contracts with various independent claims payors to administer claims for coverage and benefits under the plan options described in the PEBTF Summary Plan Description (SPD). These claims payors are empowered with the discretion and authority to make decisions on benefit claims and to interpret and construe the terms of the plan and apply them to the factual situation in accordance with their medical policies. Although the plan provides for a final level of appeal to the Board of Trustees, if a claim for benefits is denied, the member must appeal first to the claims payor in accordance with the procedures it has established for this purpose.

    If you have any questions about your health benefits, contact the PEBTF:

    Pennsylvania Employees Benefit Trust Fund (PEBTF)
    150 South 43rd Street, Suite 1
    Harrisburg, PA 17111-5700
    (717) 561-4750
    (800) 522-7279 (toll free in Pa.)
    (800) 628-0174 (toll free outside of Pa.)