Payroll/Accounts Payable

Forms and General Instructions:

***If you are adding a spouse and/or children to Health Coverage or Life Insurance, we will need a copy of your marriage license and children’s birth certificates.

How to elect a beneficiary for Basic and Optional Life Insurance:

***PEIA no longer stores Beneficiary Information, therefore the Payroll Dept. can no longer enter beneficiary information for you.

To elect beneficiaries for Basic and Optional Life you must do one of the following:

Visit: www.metlife.com
OR
Call: 1-888-466-8640

When you click Login and create an account, the website will ask you to type & select your employer or association. You must put in: West Virginia Public Employees Insurance Agency (PEIA).

You MUST WAIT until your coverage is active before you can do this.
(Typically, the 1st of the month AFTER you are hired full-time)

Forms and General Instructions:

  • BLUE INK ONLY
  • NO WHITE-OUT
  • PRINT MUST BE LEGIBLE

PERS (Public Employee Retirement System) Tier I & Tier II

DSRS (Deputy Sheriff Retirement System)

EMSRS (Emergency Medical Services Retirement System)