Retirement Forms

Retirement Forms

Mountaineer Flexible Benefits

• FBMC Retiree Enrollment form

• PEIA Retiree Health Benefits and Basic Life Insurance Enrollment Form 
  
• PEIA Retiree Optional/Dependent Life Insurance Enrollment Form 
• Premium and Benefit Assistance Form (Medicare)

• TIAA 403(b) or 457(b) Enrollment 
• TIAA 457(b) Enrollment 
• TIAA Beneficiary Change