As a medical professional, you can appreciate the need for a quality and comprehensive health insurance plan for yourself and your employees. So when the Illinois State Medical Society and Chicago Medical Society joined forces to form the Physicians' Benefits Trust, their goal was to develop a Group Health Plan that meets and exceeds your expectations.

PBT provides you and your employees a wide choice of coverage options within three plan types. This affords Large Group Practices with the ultimate flexibility in designing an employee benefits package that best suits the needs of its practice and each covered employee. To review any plan along with a brief summary of the plan's benefits, click on the plan title:

• Preferred Provider Option (PPO)



• Preferred Choice Indemnity



• Health Savings Account (HSA)-Qualified High Deductible Plans

In addition to the plan charts, the Group Health Benefits Program Brochure provides benefit highlights and features of all PBT health insurance plans.

Plus, the following benefits and features are available in all of the plans:

• Free and unrestricted choice of doctors and hospitals



• Prescription drugs - Participation in a pharmacy discount and mail order program is included. In addition, prescriptions are reimbursable as any other plan benefit.



• Coverage is guaranteed renewable.



• Premium is guaranteed for the first full year.

EMPLOYERS or BROKERS:

To receive a quote:

• Please complete the Group Census Form. You can mail or fax the completed form to your PBT sales representative to the address shown on the form. Be sure to provide all the information that is requested and, please write legibly to avoid any delays in preparing your coverage quotation.

How to Apply:

• If, after reviewing your quote, you are interested in applying for coverage, you will need to complete the Employer Application and Agreement and the Supplement Employer Application and Agreement.



• Contact our sales department (800-621-0748, press Option #2) to make sure there are no other items which, if provided, can make the underwriting process more efficient. You can mail or fax the completed forms to your PBT sales representative to the address shown on the forms. Be sure to provide all the information that is requested and please write legibly to avoid any delays in processing your application.



• You'll need to complete the Employer Application and Agreement, the Supplement to Employer Application and Agreement and provide any additional information. You can mail or fax the completed forms to your PBT sales representative to the address shown on the forms. Be sure to provide all the information that is requested and, please write legibly to avoid any delays in processing your application.



• An offer of coverage is not guaranteed and may be declined based on the medical history of the group.

EMPLOYEES APPLYING FOR COVERAGE

• Each employee must complete the Group Application/Change of Coverage Form



• Provide all the information that is requested. Print legibly to avoid any delays in processing your application.



• Return your completed form to your Employer or Program Administrator.

FOR EMPLOYEES CURRENTLY INSURED IN A LARGE GROUP PLAN WHO ARE ADDING DEPENDENTS and/or HAVE CHANGES to MAKE on EXISTING COVERAGE.

Click here and follow the instructions on the Supplemental Application/Change of Coverage Form. Return your completed form to your Group Administrator.