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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.
Standard Form 15, SF-15, or Application for 10-Point Veteran Preference, is a form that federal agencies and the Office of Personnel Management (OPM) use for the verification of an individual’s eligibility for veteran’s benefits, in accordance with the Veterans’ Preference Act of 1994.
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.
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.
The SF-15 can be found on the OPM website. Go to https://www.opm.gov/Forms/pdf_fill/SF15.pdf
PEIA forms are encouraged to be completed online. 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 .
