Peia health insurance 2026

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The document is a Health Benefits Enrollment Form for the Public Employees Insurance Agency (PEIA) in West Virginia. It is designed for employees to enroll in PEIA health insurance coverage, requiring personal and employment information, dependent details, and selection of coverage options. The form also includes sections for tobacco use declaration and employer certification.

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Click ‘Get Form’ to open the PEIA Health Benefits Enrollment Form in the editor.
Begin by filling in your personal information, including your name, address, date of birth, and Social Security Number. Ensure all details are accurate for a smooth enrollment process.
Indicate your employment details such as job title and contact numbers. If you have other insurance, provide the plan name in the designated field.
Decide whether you wish to participate in the IRS Section 125 Premium Conversion Plan by selecting 'YES' or 'NO'.
Complete the family information section for any dependents you wish to cover. Include their names, relationship codes, and Social Security Numbers as required.
Select your coverage option by checking the appropriate box for Employee Only, Family, or other plans available.
Fill out the Tobacco Affidavit section accurately to ensure eligibility for discounts on premiums.
Finally, sign and date the form at the bottom before submitting it to your benefit coordinator.

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Versions	Form popularity	Fillable & printable
2019	4.8 Satisfied (86 Votes)
2010	4.4 Satisfied (188 Votes)

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Got questions?

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 type of health insurance is MVP?

MVP Plans essentially amount to a standard Bronze Level major medical insurance plan. These plans have a high deductible and very minimal coverage for the majority of healthcare services that patients use the most.

What is the difference between PEIA Plan A and B?

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.

Is UMR and PEIA the same?

7:00 a.m. - 7:00 p.m. 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.

Is MVP Health Care part of Cigna?

MVP is a private insurance company offering Medicare Advantage (Part C) plans. These plans must offer the same coverage as Medicare Part A (hospital insurance) and Medicare Part B (health insurance), known together as Original Medicare.

How to get health insurance to cover Mounjaro?

The easiest way is to just call your insurance company and ask if mounjaro (and/or wegovy and ozempic) would be covered for you. They might say yes, no, it depends on your diagnosis, or you need prior authorization.

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