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PPO Dental Standard Plan Schedule of benefits If this is an ERICA plan, you have certain rights under this plan. Please contact your employer for additional information. Prepared exclusively for:Employer:

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First, log in to the mysgbenefitscomsob website.

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Navigate to the section labeled 'Form 4b - PPO'.

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Fill in all the required fields accurately and completely.

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Double-check all information for accuracy before submitting the form.

Who needs mysgbenefitscomsob 4b - ppo?

01

Employees who are enrolled in a PPO plan through their employer will need to fill out form 4b - PPO as part of the benefits enrollment process.

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mysgbenefitscomsob 4b - ppo is a form used for reporting employer-provided health coverage.

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Information such as employer and employee details, coverage offered, and cost of coverage must be reported on mysgbenefitscomsob 4b - ppo.

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