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Public Employees Insurance Agency Discount Waiver Request Form PEA Policyholder Address City Patient's Name Reason for use of non-network provider: State Policyholder ID# Zip Code Date of Service

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What is peia west virginia?

PEIA stands for Public Employees Insurance Agency, which is a state agency in West Virginia that provides health insurance coverage to public employees and their dependents.

Who is required to file peia west virginia?

Public employees in West Virginia are required to file PEIA forms to enroll in or make changes to their health insurance coverage.

How to fill out peia west virginia?

To fill out PEIA forms in West Virginia, individuals need to provide personal information, such as their name, address, and social security number, and choose the desired health insurance plan and coverage options.

What is the purpose of peia west virginia?

The purpose of PEIA in West Virginia is to provide affordable and comprehensive health insurance coverage to public employees and their dependents.

What information must be reported on peia west virginia?

PEIA forms in West Virginia require individuals to report personal information, dependents' information, and select health insurance coverage options.

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