Pebtf forms
[DOCX File]www.emarketplace.state.pa.us
https://info.5y1.org/pebtf-forms_1_73c43e.html
Appendix R is the summary plan description for PEBTF coverage and Appendix S is the plan handbook for State Police Enlisted Members. On page 36 of RFP under Section VII it is stated The selected “Offeror will provide up to three articles per year, as requested, for use by Office of Administration in employee communications about various ...
[DOC File]INSTRUCTIONS for STANDARD FORM 33
https://info.5y1.org/pebtf-forms_1_cdff1d.html
INSTRUCTIONS for STANDARD FORM 33. The instructions below correspond to the blocks of the form. 1. Include the DPAS rating if applicable IAW FAR Subpart 11.6 and page information.
[DOC File]Current State Business Process Assessment
https://info.5y1.org/pebtf-forms_1_bfe1f6.html
Such software now offers unstructured forms processing that uses pattern recognition technology to pull key information from scanned invoices to populate fields in the AP system. The AP staff move from data entry clerks to a role of monitoring accuracy of the imaged data.
[DOCX File]Important Notice Regarding your Health Benefits with on ...
https://info.5y1.org/pebtf-forms_1_34ad0d.html
A COBRA continuation coverage notice will be sent to you by the PEBTF regarding your health benefits. This notice will specify the coverage available, monthly rates and billing procedures. You have 60 days from the date of the notice to elect COBRA coverage. Upon electing COBRA by the required deadline, coverage will be retroactive to the first ...
[DOCX File]www.emarketplace.state.pa.us
https://info.5y1.org/pebtf-forms_1_5ad11a.html
Further analytic approaches may be discussed between the vendor, PEBTF, and DHS as appropriate. The Cost Matrix items #2 and #3 apply to work items in Tasks A.4 and A.6. Please confirm that the amount to be submitted for these items is a single fixed-fee, lump sum cost to complete these respective Tasks and that the Contractor will be paid the ...
[DOCX File]Serious Health Condition Certification
https://info.5y1.org/pebtf-forms_1_b381c1.html
A serious health condition is an illness, injury, impairment, or physical or mental condition that involves either an overnight stay in a medical care facility, or continuing treatment by a health care provider for a condition that either prevents the employee from performing the functions of the employee’s job, or prevents the qualified family member from participating in school or other ...
[DOC File]AGREEMENT AND DECLARATION OF TRUST
https://info.5y1.org/pebtf-forms_1_c161b3.html
THIS AGREEMENT AND DECLARATION OF TRUST Is made and entered into this _____day of _____, 20 _____, by and between _____, as Grantors and Beneficiaries, (hereinafter referred to as the "Beneficiaries", whether one or more, which designation shall include all successors in interest of any Beneficiary), and _____, whose address is_____, hereinafter referred to as the "Trustee", which …
COBRA Continuation Coverage Election Form
COBRA Continuation Coverage Election Form. Form completion instructions: This notice must be sent to the plan participants and beneficiaries by first class mail or hand delivered not later than 14 days after the plan administrator receives notice that a qualifying event occurred.
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