For Members
Wisconsin Public Employees Benefit Program - Administered by ETF
2010
- 2010 Summary of Benefits (SB) Local - no out of pocket expense (PDF)
- 2010 Summary of Benefits (SB) Local - $410 out of pocket expense (PDF)
- Claims Reimbursement Form (PDF)
- 2010 Formulary (PDF)
- 2010 Evidence of Coverage (EOC) (PDF)
- 2010 Pharmacy Directory (PDF)
- 2009 Summary of Benefits (SB) Local - no out of pocket expense (PDF)
- 2009 Summary of Benefits (SB) Local - $385 out of pocket expense (PDF)
- 2009 Evidence of Coverage (EOC) (PDF)
- 2009 Formulary (PDF)
- 2009 Pharmacy Directory (PDF)
- Claims Reimbursement Form (PDF)
Note: If you are not a member of an employer-sponsored plan and are enrolled in DeanCareRx, please view the 'For Members Page'.
S5954_WEB10_1010 10/22/2009
