PEIA’s financial proposal for next fiscal year includes a 3% aggregate premium increase for both employees and employers and a $200 monthly spousal surcharge increase.
The agency also proposes making several changes to a lower premium plan for West Virginia residents who receive almost all of their medical care in-state.
The finance board for the Public Employees Insurance Agency went over the plan during a meeting Thursday afternoon.
PEIA will next take out the plan for public review.
Dates and locations include:
Nov. 3 at the Highlands Event Center in Wheeling
Nov. 6 at the Beckley-Raleigh County Convention Center
Nov. 10 at the Holiday Inn Martinsburg
Nov. 13 at the Culture Center in Charleston
Nov. 17 at the Mountainlair Student Union in Morgantown
Nov. 20, a virtual town hall
All of the events have registration at 5:30 p.m. with the public hearings starting at 6.
PEIA’s finances have been relatively stable over this year.
The past couple of years, the agency wound up imposing sharper increases. Last year, that meant premium increases of 14% for the state fund or 16% in plans for local governments with retirees taking on a 12% premium increase. And the agency last year had to impose increases in deductibles of 40% — on average more than $300.
PEIA Director Brent Wolfingbarger noted that a recent BDO analysis found that substantial premium increases in recent years were partly caused by a lack of increases between 2018 and 2022, requiring sharp increases later to keep pace with rising costs.
For the coming year, PEIA is proposing a 3% premium increase that would apply to both employees and employers, typically government agencies. That would apply both to the state fund and to non-state agencies, like counties and municipalities, that opt into PEIA.
Retirees with PEIA are also in line for 3% premium increases.
A recently instituted surcharge for spouses who are opting for PEIA coverage will increase by $200.
There is also a proposed conversion of an option called Plan D. That’s a lower-premium plan that requires members to be West Virginia residents and receive all services in West Virginia, except for emergency care or specific procedures not covered in the state.
Under the Plan D conversion, premiums would decrease by 34 percent. The payment ratio between the employer and the employee would go from the current 80/20 to 75/25. The deductible would increase 425%, and the maximum out of pocket would increase 55 percent.