Individual Health Benefits Program:

PBT provides you and your family members with a wide choice of coverage options when it comes to health insurance. To review any plan along with a brief summary of the plan's benefits, click on the plan title:

• PBT Preferred Provider Option (PPO)
• PBT Preferred Choice Indemnity
• PBT Health Savings Account (HSA)-Qualified High Deductible Plans
• PBT Value Plans (PPO)
• PBT Value Health Savings Account (HSA)-Qualified High Deductible Plans
• PBT Major Medical High Deductible Plan

In addition to plan charts, the Individual Health Benefits Program Brochure provides benefit highlights and features of each PBT health care plan.

How Do I Get Started? To receive a quote:

• Complete the Individual Census Form and mail or fax it 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.

To Apply for Coverage:

• You must complete the Individual Census Form for Individual and Family Health Insurance Coverage.



• Please complete the PBT Individual and Family Supplemental Application and return it along with the Illinois Standard Health Application for Individual and Family Health Insurance Coverage.


• Provide all the information that is requested.



• Print legibly to avoid any delays in processing your applications.



• Coverage may be denied based upon medical history.



• Mail (or fax) both completed forms to the address or fax number shown below.

To make Additions or Changes to Existing Coverage: click here and follow the instructions on the PBT Individual Supplemental Application/Change of Coverage Form. Mail (or fax) the completed form (s) to the address or fax number shown below.