WV PEIA Direct Draft Authorization free printable template

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THE OLD WAY P E I A D I R E C T D R A F T A U T H O R I Z A T I O N Right now as one of our members who pay your PEA monthly premium by check (we call it Direct Pay) you have to: find your monthly

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How to fill out WV PEIA Direct Draft Authorization

01

Obtain the WV PEIA Direct Draft Authorization form from the official WV PEIA website or your employer's HR department.

02

Fill in your personal details such as name, address, and PEIA identification number.

03

Provide your bank account information, including the bank name, account number, and routing number.

04

Select the desired amount to be drafted from your account and specify the frequency of the payments.

05

Sign and date the authorization form to confirm your agreement to the direct draft.

06

Submit the completed form to the designated department (HR or PEIA) as instructed.

Who needs WV PEIA Direct Draft Authorization?

01

Employees who are enrolled in the WV PEIA health insurance plan and wish to have their premiums automatically deducted from their bank account.

02

Individuals who prefer a convenient payment method to avoid late payments or penalties associated with their insurance premiums.

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What is WV PEIA Direct Draft Authorization?

WV PEIA Direct Draft Authorization is a program that allows participants in West Virginia's Public Employees Insurance Agency (PEIA) to authorize the automatic deduction of premiums or payments from their bank account.

Who is required to file WV PEIA Direct Draft Authorization?

All participants in the WV PEIA program who wish to use direct draft for their premium payments are required to file for WV PEIA Direct Draft Authorization.

How to fill out WV PEIA Direct Draft Authorization?

To fill out the WV PEIA Direct Draft Authorization, participants must complete the required form by providing personal information, bank account details, and signing the authorization for the deduction.

What is the purpose of WV PEIA Direct Draft Authorization?

The purpose of WV PEIA Direct Draft Authorization is to facilitate timely and automatic payment of insurance premiums, ensuring continuous coverage without the need for manual payments each period.

What information must be reported on WV PEIA Direct Draft Authorization?

The information that must be reported includes the participant's name, address, account number, routing number, and authorization for the direct draft arrangement.

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