Documentation Required - Changes in Status
New enrollees and existing plan members are required to submit documentation to PEIA to be eligible to enroll. Coverage cannot be approved until documentation is received.
New enrollees must submit documentation to verify eligibility of any dependents they are enrolling for coverage, such as a marriage certificate, birth certificate or adoption papers. For a complete list of acceptable documentation, please click on
Documentation Required.
Existing plan members must submit documentation of a qualifying event to make a change outside of the Open Enrollment Period, and must submit documentation verifying eligibility of any dependents being added to the plan. For example, if an employee is adding a spouse and children to coverage because the spouse lost his/her job and insurance coverage, the employee would need to provide:
1. A letter from the spouse’s employer stating the termination or retirement date, what coverage was lost, and dependents that were covered.
2. A marriage certificate
3. Birth certificates, adoption papers or dependency affidavits for dependent children being added to the plan