FOR COVERAGE BEGINNING JANUARY 1, 2021
MEDICAL, DENTAL CRITICAL ILLNESS & ACCIDENT INSURANCES
WHEN: OCTOBER 27, 2020 - NOVEMBER 09, 2020 (TWO WEEKS)
2021 Summary of Benefits Coverage
Once a year the Board of Trustee’s set a period of time during which any eligible person may elect
to start, end or change coverage and which dependents shall be covered under the plan without the
need of a qualifying event. A qualifying event is defined as marriage, divorce, birth, and certain
changes to coverage through a spouse’s employer or death. Changes to enrollment status in the plan
may take place at any time during the year with a qualifying event, but only during Open Enrollment
without a qualifying event.
IF YOU ARE NOT MAKING ANY CHANGES, YOU DON’T NEED TO DO ANYTHING.
COVERAGE TYPE WILL NOT CHANGE.
Procedure for Fire Rescue Employees
For changes to Medical and Dental you must login to the MyBenefits portal in Peoplesoft. If you are
having trouble, there is a training manual on Target Solutions. For changes to Accident or Critical
Illness coverages, these must be completed on the Reliance Standard website: www.mybensite.com/pbcff
Procedure for Retirees
For changes to Medical or Dental you can download a 2021 Retiree Status change form from the
Benefits Fund web site. Complete the form and return to fax, email or by USPS to the address at the
bottom of the form. Forms must be post marked or returned to the Benefits Fund Office by end of
day November 9, 2020. RETIREE STATUS CHANGE FORM