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Starting July 1, 2025, the Spousal Surcharge will be increasing to $350* per month.
Under the expanded eligibility guidelines, adults aged 19-64 are eligible for Medicaid with a household income up to 138% of the poverty level. For a single adult in 2025, that amounts to $21,597 in total annual income2 (Medicaid eligibility can also be determined based on current monthly income).
PEIA was established under the Public Employees Insurance Act of 1971, to provide hospital, surgical, group major medical, prescription drug, group life, and accidental death and dismemberment insurance coverage to eligible employees; and to establish and promulgate rules for the administration of these plans.
Please note: UMR and PEIA do not pay for Couples Counseling. But they will cover family sessions for children and parents.
Public Employees Insurance Agency 601 57th St., SE, Suite 2. Charleston, WV 25304-2345.
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Plan A has the richest benefits with the highest premiums of all the PEIA PPB Plans. It is available to all active employees and non-Medicare retirees. Plan B offers lower premiums with higher deductibles, higher out-of-pocket maximums, increased coinsurance, and higher copayments for prescription drugs.
PEIA PPB Plans The medical coverage is identical in PPB Plans A and B. The differences are in the annual deductible, out-of-pocket maximums and drug co-payments. PEIA PPB Plan C is an IRS-qualified High Deductible Health Plan which can be paired with a Health Savings Account (HSA).
UMR is PEIAs third-party administrator that handles medical claim processing, case management, utilization management, precertification, prior approval and customer service for the PEIA PPB Plans. Contact UMR for answers to questions about eligibility, benefits and networks.

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