When am I eligible?
You are eligible for medical and dental benefits on the first day of the month following 30 days of employment.

Are my dependents eligible?
The employee’s spouse and dependent children less than nineteen years of age. This requirement is waived if the child is at least 19 years but less than 27 years of age and is a regular full-time student (refer to the Dependent Definition in the Summary Plan Description (SPD) for additional dependent requirements).

If I do not enroll now (including dependents), can I enroll at a later time?
If you do not enroll during your initial eligibility period, you will only be able to enroll in the Plan if you have a loss of other coverage due to exhaustion of COBRA benefits, loss of eligibility or loss of an employer contribution. You may also enroll yourself and/or your dependents in the case of marriage, birth, adoption or placement for adoption. THIS MUST BE DONE WITHIN 31 DAYS OF THE EVENT!! Refer to the Summary Plan Description (SPD) for more details.

What are my benefits?
Your health and dental benefits are outlined in the Summary Plan Description (SPD).

How do I file claims?
If you use a Participating Provider, they will file your claim for you. If you are using a Non-Participating Provider, you are to file your claim with Midlands Choice for reimbursement according to the Plan benefits.

Medical Claim Form
Dental Claim Form

How often are claims processed?
Claims are processed daily. To check on the status of a claim you can call 1-800-435-5694 or log on to the PBA Member Service center at http://www.pbaclaims.com .

What is Pre-Admission Certification?
A program for authorizing hospital admissions prior to the time of service.

Who do I call for Pre-Admission Certification for a hospitalization?
Contact Bowers & Associates at 1-800-841-0278 for pre-admission certification. Although some providers may call for pre-admission certification, it is your responsibility to contact PBA. Failure to do so will result in a penalty . See your Summary Plan Description for details.

Who do I call if I have a question regarding eligibility, benefits, processing of a claim etc.?
You may call a PBA Customer Service Representative at 1-800-435-5694. You will be asked for the ID of the Palmer employee in order to access this information.