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.
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 (PBB) Plans
- The Health Plan
PEIA PBB Plans
PEIA offers the PEIA PPB Plans A, B and C to all active employees.
Plan A is the standard plan. Plan B is similar to Plan A, but offers lower premiums with higher deductible, higher out-of- pocket maximums, and higher co-payments for prescription drugs. The medical coverage is identical in PPB Plans A and B. The differences are in the 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) or a Health Reimbursement Arrangement (HRA).
When considering a PBB 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 restrictions on 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 PBB Plan?
Questions about medical claims should be addressed to HealthSmart. (888) 440-7342
Questions about prescription drugs should be addressed to Express Scripts. (877) 256-4680
Questions for PEIA should be addressed to the West Virginia Public Employees Insurance Agency. (888) 680-7342
PBB Plan Pre-certification & Out of State Referrals
Requests for pre-certification or out-of-state referrals for medical care should be addressed to HealthSmart. (888) 440-7342
Are you getting all of the PEIA discounts that you deserve? Click here to see what you need to do to get your premium discounts.
The Health Plan
The Health Plan is a Health Maintenance Organization (HMO).
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 be referred for specialty care.
- PPO (Preferred Provider Organization) offers both “in and out-of-network” services.
- Premium contributions are set by the managed care plans and are based on salary.
- Plans have deductibles and co-pays and annual out-of-pocket maximums.
- Members must choose a Primary Care Physician.
Questions about the Health Plan
Questions about The Health Plan should be directed to The Health Plan. (800) 624-6961
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).
COBRA is available for all PEIA’s insured, including those under managed care, and is administered by Wells Fargo TPA.
- An election to continue coverage under COBRA must be made within 60 days of the end of coverage.
- To enroll for COBRA benefits, contact Wells Fargo TPA.
- When an employee terminates or resigns, they complete a form for PEIA that will automatically initiate the COBRA process.
Questions about COBRA?
Questions about medical claims should be addressed to Wells Fargo. (888) 440-7342
Dental /Vision Insurance and Flexible Spending:
Full-time employees may enroll in dental, vision, and flexible spending accounts with Mountaineer Flexible Benefits, as well as long-term disability with The Standard through FBMC.
Mountaineer Flexible Benefits
Mountaineer Flexible Benefits provides optional insurance coverage, including dental benefits, optical benefits, flexible spending accounts, disability insurance and more. Not all PEIA members are covered under the plan. Members who are covered bear the cost of optional insurance with pre-tax earnings. Retirees can elect for some coverage with after-tax earnings. To learn more, call 1-800-342-8017.
- Mountaineer Flexible Benefits for Active Employees Forms
- Mountaineer Flexible Benefits for Retirees Forms
Long-Term Disability (LTD) insurance is available to full-time employees through The Standard. For a description click here and for the enrollment form click here. Other LTD plans are available through Mountaineer Flexible Benefits. Please note the differences between the stand alone LTD plan and those through Mountaineer Flexible Benefits.
Affordable Care Act Notice
One of the requirements of the Affordable Care Act (sometimes referred to as “Obamacare”) is that employers notify employees before October 1, 2013 of the Health Insurance Marketplace. For information about the Marketplace and how this law may affect you, please read these notices: Notification | Coverage Options
Aflac Policies Available to Employees
Shepherd University is partnering 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. The Aflac policies that will be offered to Shepherd employees are: (1) Accident; (2) Cancer/Specified Disease; (3) Hospital Confinement Indemnity (for example, maternity); (4) Hospital Confinement Sickness Indemnity; and (5) Specified Health Event. For additional information, please visit Aflac and click on the Policies tab at the top of the page.