Wv electronic funds peia 2026

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The document is an Electronic Funds Transfer (EFT) Authorization Form for WV PEIA, WV CHIP, and AccessWV, allowing organizations to request or change their EFT payment details for claims. It requires information about the provider's legal business name, tax ID, contact person, and financial institution details, along with an original voided check. The form must be signed and returned to Wells Fargo Third Party Administrators.

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Click ‘Get Form’ to open the wv electronic funds peia in the editor.
Begin by filling in your organization’s legal business name and Federal Tax ID#. Ensure accuracy as this information is crucial for processing payments.
Complete the address section with your organization's street address, city, state, and zip code.
Provide the contact person's name, title, telephone number, and email address. This individual will be responsible for billing and payment inquiries.
In the financial institution information section, enter the ABA (Transit Routing) Number and Checking Account Number. Include the name of your financial institution along with its contact details.
Make sure to include a voided check with this form to verify your account details.
Finally, sign and date the form at the bottom. Ensure that all fields are completed before submission.

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We have answers to the most popular questions from our customers. If you can't find an answer to your question, please contact us.

What is WV Treasury PEIA?

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.

Does PEIA cover marriage counseling?

Please note: UMR and PEIA do not pay for Couples Counseling. But they will cover family sessions for children and parents.

What is the difference between PEIA plan A and B?

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).

What eye insurance do WV state employees have?

Vision Care: MetLife Vision Plan offers two plans to help pay for eye care needs. Employees may select either plan. Full Service Plan pays for glasses and frames or contacts in the same year.

What does PEIA stand for?

Public Employees Insurance Agency 601 57th St., SE, Suite 2. Charleston, WV 25304-2345.

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What is PEIA UMR insurance?

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.

Wv electronic funds peia 2026

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