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PEIA > Forms & Downloads

Forms & Downloads

Members

Improve Your Score Form
Tobacco Affidavit
Enrollment Forms
Shopper's Guides
Summary Plan Descriptions
Preferred Provider (PPB) Plans
Prescription Drug Benefits
Medical Home Program
Life Insurance
Mountaineer Flexible Benefits
PEIA Letters
PEIA Policies
Health & Wellness
Health Tips
Patient Audit Form
Other Documents

Providers

Case Managed Drugs
Fee Schedules & Manuals
Historic Fee Schedules
Summary Plan Descriptions
Preferred Provider (PPB) Plans
Presciption Drug Benefits (members)
Prescription Drug Benefits (retirees with Medicare)
Medical Home Program
PEIA Letters
PEIA Policies
Other Documents

Retirees with Medicare

Tobacco Affidavit
Humana
Medicare Advantage Plan Booklets (Humana)
Special Medicare Plan Booklets (PEIA)
Prescription Drug Benefits
Life Insurance
Mountaineer Flexible Benefits
PEIA Letters
Health & Wellness
Health Tips
Other Documents

Financial Reports

Comprehensive Annual Financial Report (CAFR)
PEIA Actuarial Reports
Other Post-Employment Benefits (OPEB) & RHBT
Independent Auditors Reports
Other Documents

Benefit Coordinators

Enrollment Forms
Shopper's Guides
Summary Plan Descriptions
Premium Rates
Preferred Provider (PPB) Plans
Life Insurance
Mountaineer Flexible Benefits
Training & Instructional Documents
Benefit Coordinators Reference Manual
OPEB Plan Participation Standards
Payroll & Financial Reporting Information
Other Documents

Miscellaneous

Requests for Proposals / Quotations
Notice of Privacy Practices
Other Documents

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