Preferred Provider (PPB) Plans

Summary of Benefits and Coverage

PEIA has a new tool for viewing and comparing the Preferred Provider Benefit (PPB) Plans. The Summary of Benefits and Coverage (SBC) gives you some details about the plans, and shows you samples of the cost sharing in the plans. Simply go to SBC and answer a few questions – you’ll get a .pdf report on the plans you’ve chosen. Learn more about insurance coverage that's available and your out-of-pocket costs.

Click here for Summary of Benefits and Coverage

To view plan features, you must have Adobe Reader installed on your computer. Go to get.adobe.com/reader to download Adobe Reader. Double click the file and follow the on-screen instructions to install.

You can also receive a hard copy of the SBC by mail. Just call PEIA’s Customer Service Unit at 1-888-680-7342 to request your SBC.

Announcements

Important announcements and updates about Preferred Provider (PPB) Plans ... Learn more.

Features

• Premium Discount Programs
• Medical Home Program
• Comprehensive Care Program (CCP)
• Aetna Out-of-State Network
• Hemophilia Program

General Information

• Find a Doctor
• Preventive Services Covered by Affordable Care Act
• Claims and Appeals
• Special Eligibility Situations
• Court-Ordered Dependents
• Third-Party Administrator
• Explanation of Benefits (sample)

Prescription Drug Benefits

• High-Performance Preferred Drug List (Plans A, B, C and D)
• High-Performance Preventative Drug List (Plan C)
• High-Performance Formulary Tier Listing
• Retail Maintenance Network
• Maintenance Medications List
• Common Specialty Medications
• Case Managed Drugs
• Prior Authorizations / Drugs with Special Limitations

What is Preferred Provider (PPB) Plan C?

Plan C is a high-deductible health plan which can be paired with a Health Savings Account (HSA) or a Health Reimbursement Arrangement (HRA) ... Learn more.

What is Preferred Provider (PPB) Plan D?

Introduced for Plan Year 2013, Preferred Provider (PPB) Plan D covers West Virginia residents only, and with few exceptions, all services are provided in West Virginia ... Learn more.

Mountaineer Flexible Benefits

Find out about optional insurance available with pre-tax earnings through Mountaineer Flexible Benefits ... Learn more.

Popular Downloads

Shopper's Guide
Summary Plan Description

Go to Forms & Downloads