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Comprehensive list of Forms and Documents. Alphabetical list of PEIA forms and documents . Documents for Benefit Coordinators
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.
Full instructions can be found here. ***If you have previously had PEIA as your insurance carrier, you are unable to use Manage My Benefits to log in and enroll. Please see your HR department to fill out paper enrollment forms. Preferred Provider Benefit (PPB) Plans. Comprehensive Care Program Enrollment Form.
Your completed copy of this election form (SF 2817) and the FEGLI Program Booklet constitute your certificate (proof) of insurance. These publications, as well as comprehensive FEGLI information, are available at www.opm.gov/healthcare-insurance/life-insurance.
Download Fillable Form Sf-2817 In Pdf - The Latest Version Applicable For 2024. Fill Out The Life Insurance Election Online And Print It Out For Free. Form Sf-2817 Is Often Used In Federal Benefits, Open Enrollment, Sf Forms, Federal Employees, Federal Government, Beneficiary Designation Form, Life Insurance Form, Retirement Plan Documents, ...
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.
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 .
