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Comprehensive List of Forms and Documents. Health Care Providers. Medicare Retirees. Non-Medicare Retirees. Life Insurance Forms, Documents, and Information . Notice of Privacy Practices. Requests for Proposals / Quotations / Information.
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.
A West Virginia last will and testament is a legal document that allows an individual ("testator") to outline their wishes for distributing their personal and real property, fiduciary assets, digital property, and any other property after their death. Create Document. PDF Word ODT.
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.
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.
Use Legacy's free obituary template to customize and write a beautiful tribute to your loved one. We also have downloadable templates in google docs that you can customize for word or as...
An employee may at any time file an SF 2817 to waive or reduce coverage, unless the employee has assigned his/her insurance coverage. If the employee has assigned the insurance, only the assignee(s) may waive or reduce the coverage (except for Option C which cannot be assigned). 2.
