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Comprehensive list of Forms and Documents. Alphabetical list of PEIA forms and documents . Documents for Benefit Coordinators
- Find a Form Or Document
The following is an alphabetical list of forms and documents...
- Enrollment Forms
Enrollment Forms. If a form has (Complete Online) next to...
- Find a Form Or Document
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.
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 .
State of West Virginia Public Employee Insurance Agency Health Benefits Enrollment Form. Complete this form to enroll for health coverage. Complete all sections of the form except “AGENCY” HEALTH. September 2019.
If you are unable to complete the electronic enrollment via the PEIA website you may enroll in coverage using the paper enrollment form labeled “ Enroll For Me ”, located at https://www.charlestonwv.gov/government/city-departments/human-resources/open-enrollment .
