Documents and Resources
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2024 WVU Medicine Summary of Benefits
2024 WVU Medicine Evidence of Coverage (EOC)
2024 Marshall Health Summary of Benefits
2024 Marshall Health Evidence of Coverage (EOC)
Forms and Policies
Accessing Care During a Disaster
Appointment of Representative (AOR) Form
Diabetes Prevention Program (MDPP)
Flex Card Refund Form
Fraud, Waste and Abuse Reporting
HIPAA Release Form
LIS Premium Summary Chart
Medical Management Policies & Transparency Tool
Medicare Coverage Requests, Appeals, and Grievances
Member Complaint and Appeal Form
Member Medical Claim Form
Non-Discrimination Policy
Notice of Privacy Practices
Transition of Care Form (New Members)
Report a Compliance Concern
Terms and Conditions
Plan Related Documents
Provider Directory
Explanation of Benefits (EOB)
Prescription Drug and Pharmacy Information
Medication Therapy Management (MTM)
Prescription Drug Transition Policy
Pharmacy Directory
Member Part D Claim Form
Navitus Member Portal
More Great Benefits
Thank you for choosing Peak! Please see the contact information below for the exciting supplemental benefits you now have access to as a Peak member. Please reference your benefit summary for details regarding these benefits.
Benefit
Member Service Phone Number
Web Address