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Geisinger Health PlanCommercial · Administrative · Medical Policy · PAHigh impact

Change in Coverage for PEBTF Members

Act
by Dec 31, 2025
Effective date
Jan 1, 2026
Identified
Jul 29, 2026

Summary

Effective January 1, 2026, PEBTF health coverage transitions from Geisinger Health Plan (GHP) to Aetna's Custom HMO plan. All claims for PEBTF members with dates of service after December 31, 2025, must be submitted to Aetna, not GHP. Claims submitted to GHP for 2026 services will be denied due to coverage termination.

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What to do

by Dec 31, 2025 · 5 steps
01Billing team must update all systems, templates, and workflows to route PEBTF Custom HMO claims to Aetna instead of GHP for dates of service on or after January 1, 2026.
02Update patient demographic records in billing software to reflect new carrier and obtain new Aetna member IDs from patients.
03Front desk staff must collect new Aetna insurance cards at check-in for all PEBTF members beginning January 1, 2026.
04Billing team must continue processing any outstanding claims for GHP-covered services through December 31, 2025, ensuring they are filed before timely filing deadlines.
05Flag any claims received with 2026 dates of service on GHP cards for rejection and resubmission to Aetna to prevent denials.

Original notice

Change in Coverage for PEBTF Members
geisinger.org · Always check the source before changing claims.
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