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HEALTH INSURANCE PLAN
 

Fairmont State, through the WV Public Employees Insurance Agency (PEIA), offers a choice of a preferred provider benefit plan (PPB),  managed care plans (HMO), and preferred provider organization (PPO) for employees and their dependents health plan coverage. Employee premiums are based on annual base salary, coverage type (single or family), and the plan selected. Some plans base their premiums on tobacco use. New hires have the month of hire and the following two months to select coverage. Coverage is effective the first of the month following the month of enrollment in the plan. Premiums are taken on a pre-tax basis.

Visit the PEIA Website

PEIA PPB PLAN (Preferred Provider Benefit)
  • Premiums are decreased for non-tobacco users.
  • Employees pay annual deductible and co-insurance amounts up to an annual out-of-pocket maximum. Both amounts are determined by annual salary.
  • New employees are subject to pre-existing condition limitations, unless they have evidence of comparable health coverage in the 62 days prior to the time they enrolled for PEIA PPB Plan coverage.
  • There are restrictions on traveling outside West Virginia to get medical care.
  • Prescription drugs have a separate annual deductible and out-of-pocket maximum.
Who To Call With Questions:
Medical Claims (Preauthorizations)
Wells Fargo 1-888-440-7342
Prescription Drugs (ID cards)
Express Scripts 1-877-256-4680
Precertification
Wells Fargo 1-888-440-7342

PEIA Managed Care Plans (HMO and PPO Options)
HMO (Health Maintenance Organization) — HMO's manage health care for their members by coordinating the use of health care services through their Primary Care Physicians. Members must be referred for specialty care.
PPO (Preferred Provider Organization) offers both "in- and out-of-network" services.

Managed Care Plans

Carelink - www.chcarelink.com - 1-800-348-2922
The Health Plan - www.healthplan.org- 1-800-624-6961

  • Managed care health plans are offered by PEIA
  • All family members must live in the enrollment area of the plan
  • Premium contributions are set by the managed care plans, and based on salary
  • Some plans have deductibles; most charges are co-pays
  • Some of the plans offer prescription coverage for generics only
  • Members must choose a Primary Care Physician for each family member
  • All managed care plans have annual out-of- pocket maximums

For more information, visit the plan website or review the PEIA Shopper's Guide at www.wvpeia.com

   

Benefits Contact Info

Colleen Roberts, Benefits Specialist
Room 324 Hardway Hall
Phone: 304.367.4113
FAX: 304.367.4706
E-Mail: croberts2@fairmontstate.edu