The PEIA Finance Board met December 5, 2024, and approved the plan for fiscal year 2026. The plan adopted was the same one discussed at the PEIA public hearings with a couple beneficial amendments adopted, thanks to WVEA’s testimonies given at the hearings. Here’s a quick breakdown of what’s included:
- An average 14% premium increase for state employees (an average monthly increase of $31.50).
- An average 12% increase in premiums for retirees and non-Medicare retirees.
- A 40% increase in deductibles and out-of-pocket maximums for employees and non-Medicare retirees (an average annual deductible increase of $355 and an average annual out-of-pocket increase of $1,610).
- The spousal surcharge will go up from $147 to $350 for those participants whose spouse is employed in the private sector and has medical insurance offered by their employer.
- Additionally, there will be increases in copays for therapy, ER visits, inpatient/outpatient care, and prescriptions.
The PEIA Finance Board was limited in changes they could make in the plan. The most impactful financial changes can only be made by the Legislature during the 2025 Legislative Session that begins February 12, 2025. However, the PEIA Finance Board members did make two important amendments to the proposed plan. First, they agreed to remove a proposal that would have collapsed salary tiers in the wage-based insurance plan from 10 to 5. This would have created a system of winners and losers, with those making the lowest salaries paying more and those at the top of the scale paying less. That will no longer happen and there will still be 10 tiers. Second, they voted to keep the current retiree premium and benefit assistance program. This program helps retirees in certain income brackets with PEIA costs. Retirees who qualify are encouraged to apply for this assistance. Please contact PEIA for more information.
While these amendments represent a small victory, there’s still more work to do. And that’s where participant involvement comes in. Your help is needed to stabilize PEIA!
Call your legislators and set up local meetings with them before the 2025 Legislative Session begins. Share your personal stories with them and the effects these increases will have on you and your family. Impress the importance of changing the current 80/20 language to “the state shall pay no less than 80% and the employees shall pay no more than 20%.” This allows the state to use the large amounts of surplus to offset costs to employees without triggering a premium increase. If you haven’t done so yet, please sign and share the online petition. You can find the petition on the homepage of the WVEA website.
Your involvement is crucial in stabilizing PEIA and ensuring our collective voice is heard.