Search results
Comprehensive list of Forms and Documents. Alphabetical list of PEIA forms and documents . Documents for Benefit Coordinators
- Enrollment Forms
Enrollment Forms. If a form has (Complete Online) next to...
- Enrollment Forms
The following is an alphabetical list of forms and documents on the Web site. If you see (Complete Online) next to a form, you can do this online by going to Manage My Benefits. It's easier, faster and leads to fewer mistakes than printing a form and sending it to PEIA.
Enrollment Forms. If a form has (Complete Online) next to it, you can do this online by going to Manage My Benefits. It's easier, faster and leads to fewer mistakes than printing a form and sending it to PEIA. Full instructions can be found here.
The WV PEIA Prior Authorization form is a document required by the Public Employees Insurance Agency (PEIA) in West Virginia to gain pre-approval for certain prescriptions or medical services before they are provided.
Manage My Benefits (select to complete PEIA forms online) After completing the PEIA benefits enrollment online through the PEIA website, complete the basic life and optional life insurance beneficiary for m on the MetLife website by clicking here .
meet with a benefits coordinator to discuss retiree benefits 1-844-55-WVA4U (1-844-559-8248) for further information. available and complete your enrollment form. on billing if you go on approved, unpaid leave.
State of West Virginia Public Employee Insurance Agency Basic Life Enrollment Form Complete this form to enroll for Basic Life Insurance. Complete all sections of the form except “AGENCY” f PEIA does not collect Beneficiary information. Please contact MetLife at or visit their website to Decreasing Term Benefit For Active Employees for:
