With the recent passage of Senate Bill 268, PEIA is required to charge a monthly spousal surcharge if your spouse is eligible for employer-sponsored coverage through his/her employer, but has chosen PEIA coverage instead.
If your spouse is eligible for coverage as an employee of a PEIA-participating agency, does not work, has Medicare, Medicaid or TRICARE/Champus OR is retired, the spousal coverage surcharge is not applicable.
Please log on to PEIA’s Manage My Benefits site at peia.wv.gov, choose Open Enrollment, and follow the prompts to complete your open enrollment and report your spouse’s coverage status. PEIA has mailed affidavits to all affected policyholders. If you do not go online to complete the affidavit, please complete the paper one and return it to PEIA no later than June 1, 2023.
If you do not report your spouse’s coverage status to PEIA by June 1, 2023, and your spouse remains on your PEIA-sponsored coverage, we will assume your spouse has employer-sponsored coverage available, and you will be charged the surcharge.
If your spouse’s coverage status changes - spouse loses or obtains health coverage through their employer, you must report the change in writing to PEIA during the month the change occurs or the two following months. Failure to notify PEIA in a timely manner will result in your being billed for any additional spouse surcharge due, and no refunds will be granted. If you remove your spouse from your PEIA coverage, that loss of coverage is a qualifying event for your spouse to add coverage under his/her employer’s coverage. PEIA can provide you documentation of the termination of coverage, just call us at 1-888-680-7342. If your spouse drops coverage from their employer, that is a qualifying event to add them to your coverage, but the spousal surcharge will apply.