PEIA wants your input. We are revising our forms to take advantage of the scanning and optical character recognition (OCR) functionality in our new system. Once this system is fully implemented, all paper forms sent to PEIA will be scanned and optically 'read' before they are reviewed by a staff member.

We have now been through several drafts of the forms, reducing the number of forms each time. The draft you'll see here is the latest. This form will replace ALL of the forms you currently use with Active Employees. It combines the health, basic and optional life insurance enrollment forms, the change in status form, the change of beneficiary form, the change of address form and the termination form. EVERYTHING will be done on this one form. Click on Draft Active Employee Enrollment & Change form below to review the form.

The form has to be formatted this way for the scanner to read it. It may actually look different once the final layout is done, but this will give you a feel for what we're considering.

Please take a look at it. Use your expertise as a benefit coordinator to help us finish the development. Do you understand it? Do you think your employees will understand it? How about a new hire? Do you see things we could do to make it easier to understand? Do you think we should try to do all of this on one form, and if not, how many separate forms do you think we need and how would you break them up?

Please e-mail your comments and suggestions to Jan Long at Janice.E.Long@wv.gov

Thanks for your help!!