Marshall University offers health insurance for active employees and retirees through West Virginia Public Employees Insurance Agency (PEIA). Basic and major medical insurance benefits cover hospital and surgical services, physician expenses, laboratory fees, x-ray services, and prescription drugs. There are seven (7) health benefit plans.
Coverage for Insurance is Employee Only, Employee and Child(ren), Family, and Family with Employee Spouse.
- Benefits-eligible employee.
- Spouse of eligible employee.
- Children ages birth to 26
Enrollment period is the month of hire and the following two calendar months. Coverage begins the first day of the month after enrollment and employment. EXAMPLE: An employee is hired January 17 but does not complete enrollment process until February 1, coverage would begin March 1. However, if employee completes enrollment prior to January 31, coverage would begin February 1. Premium is based upon salary and type of coverage, use of tobacco, etc. Changes in existing health care coverage can be made during “open enrollment” which occurs annually in the spring OR due to a qualifying event outside of open enrollment.
Please Note – You must have Basic Life Insurance to enroll for Health Insurance or Optional /Dependent Life Insurance Coverage. You may choose to enroll in the Basic Life coverage without enrolling for Health Insurance.
This Terms to Know document will help you through the health insurance process.
Health benefit plans:
- PEIA PPB Plans & Rates
PEIA offers four plans:
- PPB Plan A
- PPB Plan B
- PPB Plan C
- PPB Plan D – For WV Residents Only
- The levels of coverage include Employee Only, Employee and Child(ren), Family, and Family with Employee Spouse.
- Monthly premiums are based on the employee’s annual salary and type of coverage elected.
- All plans are eligible to receive a $25 tobacco free discount for employee policies and a $50 discount for employee and child(ren) and family policies.
These are Preferred Provider Benefit (PPB) plans. PPB Plan A pays for a wide range of health care services for employees and their dependents. These plans are based on the yearly base salary of an employee.
The benefits are identical and include hospital services, medical services, surgery, durable medical equipment and supplies, and prescription drugs. The difference in these plans are the deductibles and out-of-pocket maximums.
You should review all online material in the PEIA Shopper’s Guide as this presentation cannot cover all information.
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These are Preferred Provider Benefit (PPB) plans. PPB Plan B pays for a wide range of health care services for employees and their dependents. These plans are based on the yearly base salary of an employee.
The benefits are identical and include hospital services, medical services, surgery, durable medical equipment and supplies, and prescription drugs. The difference in these plans are the deductibles and out-of-pocket maximums.
You should review all online material in the PEIA Shopper’s Guide as this presentation cannot cover all information.
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This is a High Deductible Health Plan (HDHP) and can be paired with the Health Savings Account (HCA). The HDHP premium is not salary based.
A HDHP is a plan that includes higher annual deductible than typical health plans. This plans also has higher out-of-pocket maximum that includes amounts paid toward the annual deductible and any coinsurance that you must pay for covered expenses.
The deductible in this plan is combined medical services and prescription drug costs, and must be met before the plan will pay for medical services or prescription drugs. The deductible does not include premiums.
You should review all online material in the PEIA Shopper’s Guide as this presentation cannot cover all information.
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This plan you must have all services and care in West Virginia. The only services/care allowed outside of West Virginia is emergency care to stabilize patients for transport back to a West Virginia facility.
This is a Preferred Provider Benefit (PPB) plan and is based on yearly base salary.
The benefits are identical to PPB Plans A & B and include hospital services, medical services, surgery, durable medical equipment and supplies, and prescription drugs. The difference in these plans are the WV only services/care, deductibles and out-of-pocket maximums.
You should review all online material in the PEIA Shopper’s Guide as this presentation cannot cover all information.
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- Health PlansThe Health Plan offers three plans:
- Health Plan A (HMO) – Coverage Information
- Health Plan B (HMO) – Coverage Information
- Health Plan C (PPO) – Coverage Information
West Virginia’s Public Employee Insurance Agency (PEIA) is The Health Plan’s largest fully insured account, with over 14,000 members, since 1981. The Health Plan, a West Virginia company, is offered in all 55 counties in West Virginia.
You have low $10 copay for primary care visits on all three of our options! If you are an active employee or non-Medicare retiree living or working in West Virginia, you are eligible for The Health Plan.Listed below are just some of the benefits PEIA members receive:
- Ambulatory patient services
- Rehabilitative and habilitative services and devices
- Emergency services
- Lab services
- Hospitalization, maternity and newborn care
- Preventive and wellness services
- Mental health and substance use disorder
- Chronic disease management
- Pediatric services including oral and vision care
- Prescription drugs
Members can log in to our secure member area and take advantage of CoreWellness, a program that allows you to adopt and sustain behaviors that reduce your health risks, improve your quality of life and enhance personal effectiveness. You can also complete a Compass health risk assessment and take a Journey towards bettering your health. For more information, you can call 1.888.847.7902 or email us at info@healthplan.org.
If you are already enrolled with The Health Plan and wish to continue your membership, no action is necessary. Your enrollment will continue automatically.
- Health Plan A (HMO) – Coverage Information
