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Forms & Downloads

 
 

Comprehensive list of Forms and Documents

Alphabetical list of PEIA forms and documents

Documents for Benefit Coordinators 

 

Documents for Health Care Providers

 

Enrollment Forms

 

Fee Schedules & Manuals

 

Financial Reports

 

Miscellaneous

Policies & Letters

Prescription Drug Benefits

 

Preferred Provider Benefit (PPB) Plan
Medicare Advantage Plan (Humana)
Special Medicare Plan (PEIA)

Requests for Proposals, Quotations and Information

Shopper’s Guides

Shopper’s Guides (Active Members)
Medicare Shopper’s Guides

Summary Plan Descriptions

 

Wellness Tools