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Program Requirements

PEIA Wellness Program Participants: In an effort to streamline the program, administration of PEIA’s Weight Management program will be provided by PEIA staff beginning October 1, 2018.

What do I need to do if I am in the program?
Nothing.  This is a change in the inner workings of the program behind the scenes.  You should see no real changes to the program, but please make note of the new contact information below.
 
What if my facility does not have a registered dietician and I receive these services via phone calls?
Members expecting telephonic dietician services after October 1 will be contacted by a new provider and times will be scheduled for upcoming services.
 
What about phone coaches/monthly check-ins?
The phone coaching portion of the program was discontinued July 1. All Weight Management Program participants now receive monthly check-ins.  Members can choose whether to do these by text, phone call, or email.  Soon, a member of the PEIA Weight Management program staff will check in monthly to make sure you are getting all the necessary services, and everything is going well for you in the program. This team member will troubleshoot any issues you may have. Please remember these check-ins are a required part of the compliance standards for the program.
 
What about my gym and my trainer?
The network of participating facilities is not changing with this administrative change.  You will still use the same weight management facility and personal trainer. 
 
What other changes will be coming from this move?
We expect that the program will continue as described starting in July.  This Plan Year we have tightened up the participation standards, and now require monthly check-ins to be sure you’re getting the most out of the services we offer.  For details of how the program works, see below.

For further details please contact PEIA at1-866-688-7493 or Weightmanagement@wv.gov

 
Your PEIA Wellness Team

 
Maintaining a healthy weight is essential to a long and productive life. PEIA offers PEIA PPB members a weight management program which uses the services of registered dietitians and exercise professionals.

To qualify you must have PEIA Preferred Provider Benefit Insurance; be 18 years of age or older; have either a body mass index of 30 or greater, or a waist circumference of 35 inches or more for a woman or 40 inches or more for a man; have approval from your physician or nurse practitioner; and be ready to make permanent lifestyle changes.

Members are not eligible if they have undergone any bariatric surgery within the last 10 years, have exhausted the lifetime benefit, do not have approval from their physician or nurse practitioner, are under the age of 18, or if there is not yet a participating facility in the area or no facility is accepting new clients.

There is no coinsurance or deductible, only $20 per month copayment per participant with PPB Plan A, B, or D coverage. Plan C members must cover the cost of all professional appointments until their deductible is met.

Participants receive:
  • Individualized services from a registered dietician and exercise professionals;
  • Baseline assessments with monthly follow-ups;
  • Personal training;
  • Monthly staff check-ins; and
  • Access to a participating fitness facility.
As a participant, you will be obligated to do the following:
  • To complete monthly check-ins via phone, text or email;
  • To know and follow monthly schedule of appointments;
  • To keep all scheduled appointments or to provide 24 hours notice to your provider of a cancellation. Failure to do so could mean that you will be charged for the missed appointment;
  • To pick one facility and exercise 2-3 times per week for the required 10 times per month;
  • To cooperate with the monthly measurements;
  • To pay your facility copayment when due;
  • To notify your assigned staff support member if you are experiencing problems which are interfering with your participation;
  • To maintain courteous behavior;
  • To keep a food journal to be reviewed by your facility’s staff; and
  • To meet all compliance standards.

For more information, call 1-866-688-7493 or email Weightmanagement@wv.gov.

To enroll in the program on-line, go to Weight Management Enrollment.

The Centers for Disease Control and Prevention published an analysis of PEIA’s Weight Management Program in its publication Preventing Chronic Disease: Center for Disease Control and Prevention article