Premiums, drug expenses likely to rise under proposed PEIA benefits changes

CHARLESTON, W.Va. — Proposed changes to Public Employees Insurance Agency benefits include increased premiums and restrictions on prescriptions.

The possible changes were introduced Thursday during a PEIA Finance Board meeting in Charleston. A series of public hearings is scheduled over the next several weeks to discuss the proposals.

Ted Cheatham

“The goal is to take this out, say this is the concept and get feedback from the public,” said PEIA Director Ted Cheatham.

Dale Lee, president of the West Virginia Education Association, was the only member of the public to speak during Thursday’s finance board meeting. Lee said he is concerned about the likely increased costs for retirees — and also for young teachers who may be recruited for open jobs at West Virginia schools.

Under the proposal, state employees would receive a premium increase of .5 percent. Retirees and non-state employees on PEIA would receive a 2 percent rate increase.

Another change would be to go to a 30 percent payment on preferred brand prescriptions, rather than a $25 or $30 co-pay.

“We want people to shop for drugs and get the most efficient drugs,” Cheatham said during the meeting.

There were other variations in the proposal likely to affect people on PEIA.

“The big ones are, we are looking at collapsing our salary tiers and using total family income if you’re covering a spouse,” Cheatham said in a brief conversation after the meeting.

“Then we’re also gonna do what we call pay-by-the-person so we’ll have a single rate and if you wanna add your spouse or your children it’ll be extra for each one that you add.”

The salary tiers for active state employees with PEIA would change from the current 10 down to 3.

The total family income kicks in if the spouse is covered by PEIA and is defined as the sum of both married spouses’ adjusted gross income.

A form will be available to report total family income. Failure to provide it will result in a default to the highest income and premium tier.

During the meeting, Cheatham acknowledged that each individual or family would have to be carefully attuned to its own circumstances.

“Each family’s circumstance will be uniquely different under each proposal,” Cheatham said.

In response to questioning, Cheatham added, “There are some winners and losers in this environment.”

Dale Lee

Lee of the WVEA said he is worried not only about the effects of the changes on retirees but also on newly-educated teachers who may be sought to fill vacant positions in West Virginia.

“Instead of figuring out ways to enhance people and draw them into the profession, we’re looking at ways to drive them out by decreasing the benefit,” Lee said.

“We used to say, ‘Our salaries are not that great, but we have great benefits. We have a great retirement system, we have great medical insurance. And now our medical insurance is continuing to erode where it’s not the great plan any more. It’s costing you more and more to do that. That was one of the selling points we had that we no longer have.”

Lee expressed concern about several other aspects of the proposed changes.

“I’m concerned with going to the 30 percent in the preferred brand medicine with no appeal process because there are many people who can’t take a generic,” Lee said. “People can’t afford that. They’re struggling now.

“I’m concerned about the 2 percent premium increase for our retirees, many of them living on a fixed income for years, and they can’t afford to pay more. There are more things as we dive into this with the WVEA, we’ll address at the public hearings.”

The PEIA Finance Board debated some scheduling issues with the public hearings around the state.

Public hearings are set for Nov. 6 in Morgantown, Nov. 14 in Beckley and Nov. 15 in Charleston.

At one point, PEIA staff were planning to try two additional telephonic hearings in lieu of public hearings in Martinsburg, Wheeling and Huntington.

But Cheatham said some technical issues were still being worked out for the telephonic hearings.

In the end, the board decided to plan a Nov. 7 meeting in Martinsburg.

There will still be no meetings in Wheeling or Huntington.

One of the two telephonic meetings was canceled. One will still be attempted Nov. 13.

“I’m glad they put one of the meetings back, the Martinsburg meeting, because people need the opportunity to come out and voice their concerns. It’s impossible for a teacher in the Eastern Panhandle to after school leave there and get to Morgantown, which was the closest meeting to them,” Lee said.

 

 





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