State workers and teachers face moderately higher Public Employees Insurance Agency costs next year, while non-state workers in a high-deductible plan got hit fairly hard and retirees get a break.
PEIA is proposing 2% aggregate premium increases for state employees and employers for the coming year.
The proposal includes no changes to the family tier spousal surcharge, 1% benefit modifications and an employer administrative fee increase of $2.50.
Non-state agencies, the local governments that participate in PEIA, got hit a little harder. Non-state fund premiums would rise 4% for most plans and 24% for the Gold high-deductible plan, alongside 2% benefit modifications.
PEIA is proposing going ahead with a standard that participating non-state employers must have 50% of their employees enrolled in a PEIA health plan by next June 30 to participate.
And retirees got a break, with their premiums remaining unchanged for fiscal 2028; the plan lowers active-fund payments to the retiree trust and designates $187 million in investment gains as a stabilization reserve.
All of that came out during a PEIA Finance Board meeting on Thursday afternoon.
PEIA Director Brent Wolfingbarger said PEIA is a very lean operation, with minimum overhead.
“We also took into consideration stronger than expected fiscal year 2026 results. PEIA finished fiscal ’26 substantially ahead of plan, primarily due to lower than forecasted medical and prescription drug claims,” he said.
But on the non-state fund, he described worrisome trends: “Based on the non-state fund’s medical and prescription drug claims in fiscal 27 to date and its historical trends, our actuaries currently project that its fiscal year 2027 expenses will exceed its premium revenues by approximately 10 million dollars, primarily due to its Gold high deductible health plans’ poor financial performance.”
Next for the proposals will be a series of public hearings:
Nov. 9 at the Hampton Inn & Suites University Town Centre, 325 Granville Square, Morgantown;
Nov. 10 at the Beckley-Raleigh Convention Center, 200 Armory Drive, Beckley;
Nov. 12 virtually via Google Meet;
Nov. 16 at Shepherd University’s Student Center Storer Ballroom, 210 North King Street, Shepherdstown;
Nov. 17 at the WV Capitol Complex, Building 3, 1900 Kanawha Boulevard East, Charleston;
and Nov. 19 at River City Restaurant, 1400 Main Street, first floor, Wheeling.
All six hearings follow the same schedule: registration and speaker sign-in begin at 5:30 p.m., and the public hearing begins at 6 p.m.
At Thursday’s meeting, Education West Virginia co-president Dale Lee said he was pleasantly surprised that the proposed premium increases for workers on the state plan will be less than originally anticipated.
“This is shocking to me, and that is lower than what the projection was last year,” Lee said.
He also praised the absence of an increase in the spousal surcharge.
“The other thing that is impressive in this plan is that there’s no increase for our retirees,” Lee said.