Medical and Life Insurance:
Full-time employees may enroll in health and life insurance plans through the West Virginia Public Employees Insurance Agency (PEIA).
Employees currently have a choice between two primary health plans available:
- PEIA Preferred Provider Benefit (PPB) Plans
- The Health Plan
PEIA PPB Plans
PEIA offers the PEIA PPB Plans A, B, C and D to all active employees.
The medical coverage is identical in PPB Plans A and B. The differences are in the annual deductible, out-of-pocket maximums and drug co-payments.
PEIA PPB Plan C is an IRS-qualified High Deductible Health Plan which can be paired with a Health Savings Account (HSA).
PEIA PPB Plan D is a West Virginia only plan. Members enrolling in this plan must be West Virginia residents and all care must be provided in West Virginia.
When considering a PPB Plan remember:
- Employees pay annual deductible and co-insurance amounts up to an annual out-of-pocket maximum. Both amounts are determined by annual salary.
- There are some restrictions and reduced benefits when traveling outside of West Virginia to get medical care.
- Prescription drugs have a separate annual deductible and out-of-pocket maximum.
- A discount is available for employees who are tobacco free.
Questions about a PPB Plan?
Questions about medical claims should be addressed to UMR at (888) 440-7342 or on the web at www.umr.com.
Questions about prescription drug claims and benefits should be addressed to CVS CareMark at 844-260-5894 or on the web at www.caremark.com.
For questions about the West Virginia Public Employees Insurance Agency, please call (888) 680-7342 or on the web at www.wvpeia.com.
PPB Plan Pre-certification, Pre-Authorization, Prior Approval Of Out-of-State Care
These requests should be addressed to UMR at (888) 440-7342.
Please remember to keep your beneficiary information up-to-date with your life insurance and retirement plans. It is important that you control who will receive your assets in the event of your death.
The Health Plan of West Virginia, Inc.
The Health Plan is a Managed Care Plan that offers two Health Maintenance Organization (HMO) plans and one Point of Service (POS) plan.
HMO’s manage health care for their members by coordinating the use of health care services through their Primary Care Physicians.
When considering The Health Plan remember:
- Members must choose a Primary Care Physician (PCP).
- Members in an HMO plan must be referred for specialty care.
- The POS plan offers both “in and out-of-network” services.
- Premiums are set by the managed care plans and are based on salary.
- Plans have annual deductibles, co-pays and out-of-pocket maximums.
Questions about the Health Plan
For questions about The Health Plan, please call (800) 624-6961 or on the web at www.healthplan.org.
Continuing Health Insurance with COBRA
Employees and their enrolled dependents may be eligible to continue current health coverage for a limited time under the federal Consolidated Omnibus Budget Reconciliation Act (COBRA). PEIA’s COBRA program is administered by UMR. An election to continue coverage under COBRA must be made within 60 days of the end of coverage. To enroll for COBRA benefits, contact UMR at 888-440-7342.
Mountaineer Flexible Benefits (FBMC)
Mountaineer Flexible Benefits provides optional insurance coverage, including dental benefits, vision benefits, flexible spending accounts, disability insurance and more. Members who are covered bear the cost of these benefits with pre-tax earnings. Retirees can elect for some coverage with after-tax earnings. For more information or questions, contact FBMC at 844-559-8248.
Long-Term Disability (LTD) insurance is available to full-time employees through The Standard Insurance Company. Other LTD plans are available through Mountaineer Flexible Benefits.
Aflac Policies Available to Employees
Shepherd University partners with Aflac to offer benefits to full-time and part-time employees. Full-time employees can pay their premiums through payroll deduction while part-time employees can enroll on a direct pay basis (credit card/bank draft). This is not regular health insurance. For more information, please visit Aflac and contact the Human Resources Office for information on enrollment.