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2027 Plan Related Documents

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Summary of Benefits

Segment 1 Summary of Benefits

(All other WV counties)

Segment 2 Summary of Benefits

(Cabell, Lincoln, Mason, Putnam, Wayne)

Eastern Panhandle Summary of Benefits

(Berkeley, Hampshire, Hardy, Jefferson, Morgan)

Pennsylvania Summary of Benefits

(Fayette, Greene)

Explanation of Coverage

Segment 1 Evidence of Coverage (EOC)

(All other WV counties)

Segment 2 Evidence of Coverage (EOC)

(Cabell, Lincoln, Mason, Putnam, Wayne)

Eastern Panhandle Evidence of Coverage (EOC)

(Berkeley, Hampshire, Hardy, Jefferson, Morgan)

Pennsylvania Evidence of Coverage (EOC)

(Fayette, Greene)

Annual Notice of Change

Segment 1 Annual Notice of Change (ANOC)

(All other WV counties)

Segment 2 Annual Notice of Change (ANOC)

(Cabell, Lincoln, Mason, Putnam, Wayne)

Eastern Panhandle Annual Notice of Change (ANOC)

(Berkeley, Hampshire, Hardy, Jefferson, Morgan)

Pennsylvania Annual Notice of Change (ANOC)

(Fayette, Greene)

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*For prior year plan information, please contact Peak Advantage Member Service at 1-855-962-7325.