PEIA Costs Rising, Spousal Surcharge Jumps

The Public Employees Insurance Agency (PEIA) Finance Board voted Thursday to accept a proposed plan for the 2027 fiscal year. 

Health insurance premiums for public employees will rise about 3%. 

“This is an aggregate premium increase for both employees and employers to keep pace with medical inflation and to guard against the risk of needing to have massive double digit percentage increases in future years, as has happened recently,” PEIA Director Brent Wolfinbarger said.

But the biggest change in the plan, or at least the one that got the most attention in a series of public meetings around the state, was the increase on what families have to pay for non-employee spouses to be covered if they have health insurance somewhere else. 

That fee is going up $200 a month. 

“The proposed household surcharge increase of $200 is mandated based on the opinions given to us by our actuaries,” Wolfinbarger said. “So the legislature has established this policy, and if any changes to be made, that’s a legislative decision to make.”

This change and others to employee health plans will take effect July 1, 2026. 

By holding premiums flat from 2018 to 2022, PEIA didn’t keep up with rising costs. Former Gov. Jim Justice pledged there would be no rate increases “on his watch.”

Since then, rates have gone up considerably. Under the 2026 fiscal plan, premiums increased by 12% to 16%, with some copays more than doubling. Average deductibles and out of pocket maximums increased by more than $300.

Under the new plan: 

• Plan A will be named PPB Gold
• Plan B will be named PPB Silver
• Plan C will be named Gold High Deductible Plan
• Plan D will be named WV Bronze High Deductible Plan

Plan D will be converted into a lower cost plan. Premiums will decrease 34% and instead of a 80-20 plan it will drop to a 75-25 plan. The deductible will also increase by 425%. 

Additionally, people in the Bronze High Deductible Plan will receive a $500 employer funded contribution into either a health savings account or Health Reimbursement Arrangement. 

Wolfinbarger noted that there were 65 people in attendance at the Wheeling public meeting, 55 people at the Beckley meeting, 50 people in Martinsburg, 60 people in Charleston, 55 people in Morgantown and 80 people attended the virtual town hall. 

“I think it’s fair to say that probably the most contentious issue that we discussed during the public meetings was the proposed increase in the spousal surcharge in the amount of $200 per month,” Wolfinbarger said. “If an employee spouse has health insurance available through an employer, then the employer may not cover any portion of premiums for the employee spouse coverage unless the employee adds his or her spouse to his or her coverage by paying the cost of the actuarial value of the plan.”

The finance board approved the proposed plan for the 2027 fiscal year unanimously.