Living Will Affidavit for New Enrollees 

6/9/2011 
New employees can complete the Living Will affidavit online at Manage My Benefits on the WV PEIA website when they enroll for benefits. If a new employee has to complete a paper enrollment form, the new Health Benefits Enrollment Form includes the Tobacco and Living Will Affidavits on the form. It is located in the Find a Form section of the PEIA website.

Contact:

MickiAnne Henkels 
304-558-7850 ext 52633 
mickianne.henkels@wv.gov 
 

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