CHARLESTON, W.Va. — PEIA, the health insurance program for state workers, is showing better financial numbers seven months into the fiscal year.
“The good news is the plan is performing better than expected,” PEIA Director Brent Wolfingbarger told the PEIA Finance Board at its meeting Thursday in Charleston.
But Wolfingbarger added he’s not sure if the trend will continue the last few months of the budget year.
“The bad news however is that PEIA has historically experienced higher health care expenditures during the second half of the fiscal year as members their deductibles and maximize their out-of-pocket costs”
According to Wolfingbarger said health care economists expect fiscal year 2027 costs trends will continue to go up.
For now though, so far, so good.
PEIA Chief Financial Officer Jason Haught said the plan has $206.8 million in total assets with liabilities of $110 million. He said revenue is up $71 million than last year at this time. Haught said the claim expense through seven months of the fiscal year is down by $20.4 million.
Haught said the14 percent increase in premiums and deductibles beginning July 1, 2025 has had an impact on both revenues and how the plan is being used.
“We’re getting kind of a double whammy hit there. You’re seeing benefit changes and also reduced utilization,” Haught said. “That’s what I think is helping us stay below last year’s numbers in our medical expense.”
Haught said this year hasn’t been like last year–yet.
“We did not see the trends that we were exposed to in ’24 and assumed to be in ’25. Thankfully those dropped off and we’re see much better numbers due to that,” Haught said.
Public employees will see a 3% aggregate premium increase that will apply to both employees and employers beginning this coming July 1. The other change that has garnered attention is a $200 monthly spousal surcharge increase.
Legislative session
PEIA tried to get a bill passed this session, SB 1082, that would have given the agency authority to investigate and prosecute fraud.
The bill originated in the Senate Banking and Insurance Committee where it passed on Feb. 25. It was referred to the Senate Judiciary Committee which never took up the bill.
PEIA Finance Committee Chairman Eric Householder, the Secretary of Administration, said Thursday they just fell short.
“We were able to get the chairman to run the bill, we were like a day late or something, we tried but we gave it our best,” Householder said.
Wolfingbarger said it’s important to address fraud in PEIA.
“We will continue to try to do everything we can to strengthen PEIA’s ability to cut down on waste, fraud and abuse in our expenditures and hopefully work with the legislature to secure passage of a bill much like Senate Bill 1082 in a future session,” Wolfingbarger said.