Benefit Information Summary Sheets

Selection Sheet

  1. 2023 PEBB Selection Sheets
  2. 2024 PEBB Selection Sheets
  3. 2025 PEBB Selection Sheets

Medical, Vision and Dental

  1. 2024 PEBB Medical Dental Enrollment Form
  2. 2024 Uniform Medical Benefit Comparison
  3. 2024 PEBB Uniform Dental Plan Benefit Summary
  4. 2024 UMP Classic Summary of Benefits
  5. 2024 UMP Classic Certificate of Coverage
  6. 2024 UMP Select Summary of Benefits
  7. 2024 UMP Select Certificate of Coverage
  8. 2024 UMP HSA Summary of Benefits
  9. 2024 UMP HSA Certificate of Coverage
  10. 2024 MetLife Beneficiary Designation Form
  11. Verde FSA Enrollment Form
  12. 2025 Vision Plan Benefit Comparison
  13. 2025 PEBB Dental Plan Benefit Comparison
  14. 2025 PEBB Medical Benefits At A Glance
  15. 2025 PEBB Medical Benefit Comparison

Long Term Disability and Life Insurance

  1. 2024 LTD Rates
  2. 2024 MetLife Voluntary Rates