PEIA Finance Board Story Archives - West Virginia Public Broadcasting

Teachers, School Service Personnel Rally Ahead Of PEIA Hearing In Morgantown

Teachers and school service employees rallied Tuesday night ahead of a Public Employees Insurance Agency (PEIA) hearing in Morgantown.

PEIA is holding hearings across the state to receive input from state employees and retirees on proposed price increases to their health care plans that would take effect next summer. Changes include a 14 percent increase to premiums and a 40 percent increase to deductibles.

Members of the American Federation of Teachers – West Virginia (AFT) gathered outside of the Erickson Alumni Center at West Virginia University ahead of testifying in front of the PEIA Finance Board. They were joined by the West Virginia Education Association, as well as the United Mine Workers of America, who represent some school service workers.

Tena McElwain, a bus driver for Monongalia County Schools and the AFT service personnel president for the county, said the rally is a show of solidarity.

“The rally is just to show support, unity,” she said. Hopefully we can take care of PEIA this year, working through the legislatures and finding appropriate funding for it.”

McElwain said the proposed increases would cut even further into paychecks for service workers, and make vacancies even harder to fill.

“Right now there’s a shortage in Mon County for bus drivers, secretaries, aides, custodians, cooks, because of the PEIA increases,” she said. “We’re more or less working to pay insurance. We’re not taking anything home after PEIA comes out, we still have bills.”

Cullen Hencke, also a Monongalia County teacher and the vice president of the local AFT chapter, said teachers and school personnel aren’t the only ones that will be impacted by the rate increases.

“Sometimes we’re the loudest voices about these issues, but we know that they affect lots of other people who West Virginians care about and look to and in times of need,” he said.

Carol Roskos, a Monongalia County teacher and president of AFT Moningalia, echoed McElwain’s concerns of the rate increase’s economic impact.

“I would like to see the public hold their elected officials accountable for being responsible for helping West Virginia to run efficiently as a state,” she said. “If West Virginia is not taking care of their employees’ health insurance, there is a possible economic fallout that could happen if folks tend to leave the state or seek employment somewhere else.”

At least four officials elected to state office were present at Tuesday’s meeting, including Sen. Mike Oliverio, R-Monongalia, Del. Anitra Hamilton, D-Monongalia and Del. John Williams, D – Monongalia, but many attendants expressed dismay that more politicians were not present.

Del. Joey Garcia, D-Marion, was recently elected to the state senate for District 13. He spoke to the rally ahead of the hearing, and said PEIA’s problems were created by the legislature, and they can be fixed by the legislature.

“They’re fixes that an incoming governor can propose when we get into the legislative session this coming February,” Garcia said. “I’m hopeful, I think these people here are hopeful that their voices will be heard. And I just said a second ago, you can listen, or you can actually look at something, and see where people are. And I think that’s what we’re going to see a lot tonight about how this has affected people in their pocketbooks.”

Attendants at the Nov. 19, 2024 PEIA Finance Board hearing in Morgantown listen to a presentation on proposed increases.
*Chris Schulz/West Virginia Public Broadcasting*

Kristie Skidmore was elected president of AFT – West Virginia over the weekend. She echoed others and said she is concerned the rate increases will worsen the existing teacher shortage.

“A big picture that we need to look at is when members can’t afford health care, and they can’t afford to stay in the state, they’re going to go elsewhere, and they’re going to make more money, and they’re going to have better health care,” she said.

Dale Lee, president of the WVEA, said that healthcare is a national issue that cannot be fixed at the state level, but some of the burden needs to be redistributed away from employees.

“The burden of the increased cost shouldn’t be borne solely on the employee, and in this plan, more than 40 percent of the costs are going to directly to the employee,” Lee said. “Because not only do you have the premium increases of the 80/20 which, by law, you have to do, but you have $76.4 million in benefit reductions that is born solely on the employee.”

Lee pointed out that pay increases implemented by the legislature were intended to help address PEIA rate increases, but have had little effect.

“It’s really not a pay raise, because you’re not being able to have any more additional dollars for gas bills, electric bills, groceries, things like that,” he said. “You’re actually seeing your buying power decrease in this. So we really haven’t received a raise. It’s been an offset.”

The final public hearing in the series will be held in person Thursday, Nov. 21 at the Culture Center in Charleston.

Public Employees Ask PEIA Not To Raise Rates

State employees had the opportunity Monday evening to make their voices heard about proposed rate increases to their health insurance.

About 160 people attended a virtual public hearing held by the West Virginia Public Employees Insurance Agency (PEIA), to hear proposed changes to their health insurance for Plan Year 2026, beginning July 1, 2025.

On Oct. 24, PEIA and the Retiree Health Benefit Trust (RHBT) Finance Board met to discuss proposed changes to rates.

Brian Cunningham, the director of PEIA, presented the Finance Board’s proposed rate increases, then took questions and comments from the audience.

The board’s proposal includes a projected five-year plan to raise member payments and restore PEIA reserves. Those proposals include more than doubling some copays along with premium increases through 2029.

Cunningham said the rate increases can be attributed to the passage of Senate Bill 268.

The 2023 bill mandated a spousal surcharge and formalized the 80/20 rule, which requires insurance companies to spend at least 80 percent of the money they take in from premiums on health care costs and quality improvement activities.

“As it relates to spousal surcharge, the board is proposing a $350 spousal surcharge,” Cunningham said. “Currently, that spousal surcharge is $147.”

The bill also required PEIA to increase reimbursement to healthcare providers.

“The other things that are driving cost increases, (you) may have heard of Senate Bill 268, which resulted in increased reimbursement to healthcare providers,” Cunningham said. “In plan year 2024 PEIA paid out more than $70 million more in healthcare providers and reimbursement to healthcare providers, particularly inpatient hospitals.”

Finally, Cunningham said, rising prescription drug costs are spurring rate increases for employees.

“A significant driver of the cost of prescription drugs are what are known as GLP-1’s,” Cunningham said. “GLP-1’s are prescription drugs like Ozempic and Mounjaro. GLP-1’s were responsible for almost $53 million in cost in plan year 2024 which is approximately 20 percent of the overall net cost, or the overall net drug spend at PEIA.”

In March, PEIA canceled a 1,000-person pilot program that covered weight-loss drugs due in part to the program’s cost to the state. However, advocates of the program say the state will end up paying more for the health complications that will be caused by obesity.

West Virginia state employees from all walks of life voiced their concerns about increasing healthcare costs.

Retirees on the call say they worked their lives for their retirement, and these rate increases will not be feasible on a fixed income.

Teachers on the call say their salaries do not cover their expenses, but they have continued to work their state jobs for the benefits because it outweighed the cost and they care about their work.

Jamie Tallman was one of 165 West Virginians on the virtual call who spoke during Monday’s hearing. He has been teaching in Grant County for almost 40 years.

He says he and his wife will have to consider selling their home and downsizing if the rate increases are implemented. That echoes sentiments from his fellow state educators that affordable health benefits were leveling out the low salaries provided by the state.

“This would be the most severe pay cut, basically, that I would receive as an educator in all my career. And I know somebody said last night, it is a perk,” Tallman said. “The insurance has kind of been a perk, you know. We work right up there, 49th, 50th, you know, in teacher salary.”

Most speakers said if the rates are raised they will have to consider leaving the state entirely or stopping work for the state.

Cunningham encouraged PEIA members to reach out to their lawmakers to let them know their concerns.

PEIA is continuing to hold public hearings throughout the week.

First PEIA Public Hearing Draws Criticism

The first of four public hearings held by the Public Employees Insurance Agency (PEIA) Monday drew criticism about changes to the plan.

The embattled agency has struggled with fiscal solvency and most recently, the announcement by one hospital that the insurance carrier would no longer be accepted. Senate Bill 268, which goes into effect July 1, was a concerted effort between the House and Senate to rescue PEIA by requiring a minimum 110 percent reimbursement of the Medicare rate for all providers, paid for in part by a 24 percent increase in premiums for employees.

About 50 people, including retirees and several educators, were present for the meeting at the Culture Center in Charleston.

PEIA Interim Director Jason Haught talked about the three plan options on the table.

The plan changes reflect the increase in premiums for active and retired state employees. Non-state agencies, retirees, spouses employed by PEIA-participating agencies, or spouses with Medicare, Medicaid or TRICARE coverage are exempt.

Effective July 1, significant changes to the plan include:

A surcharge for spouses of active policyholders – if they have coverage elsewhere but choose PEIA coverage instead.
A hike in premiums to return to a 80/20 employer/employee premium split
Increasing reimbursement to providers to a minimum of 110 percent of Medicare’s reimbursement.

The first of the three options discussed by Haught includes an increase in state employee premiums of almost 24 percent. The increase would vary since enrollment and performance vary from plan to plan. For the non-state fund there would be a 15.6 percent increase. No premium increase would be imposed on retirees.

Option 2 calls for a blended approach with a slightly lower increase in premiums (19.2 percent) but higher deductibles, and out-of-pocket and prescription costs to make up the difference.

Non-state plans that opt into PEIA under option 2 would see a 9.7 percent premium increase and medical deductible and out-of-pocket increases of approximately 35 percent along with a hike in prescription drug costs.

Option 3 is also a blended approach (State plan & RHBT) and would include a 14.6 percent premium increase with retirees being exempt. Changes to non Medicare include a medical deductible increase of 50 percent under plan tiers, out of pocket expenses, and an increase in prescription co-pays or drug costs.

Several retirees and former educators spoke to the panel about their concerns, including Rosa Huffman, a teacher in the Kanawha County school system. Huffman asked why the public is not being given more time to understand and decide on the proposed options.

“Why is this plan being rushed through?” Huffman asked.

Sen. Amy Grady, R-Mason, said comments that the PEIA plan was rushed through the legislature are unfounded.

“It hasn’t been rushed, and that’s the misconception,” Grady said. “This specific plan has been worked on for at least a year. I know I was reaching out to people, saying ‘Give me some input on this,’ I’ve no reason to believe other senators and delegates don’t do that.”

Grady said down the road the legislature may be able to consider taking money from the state’s “Rainy Day” fund to prevent an increase in costs for retirees, a suggestion put forward by West Virginia Education Association President Dale Lee.

When asked, the panel informed Lee that there was $74 million in the fund.

“Because I know that was a part of the fiscal note when you looked at Senate Bill version of 268 – whether the premiums would go up 14 percent or 26 percent based on the $74 million in the rainy day account,” Lee said. “I’m guessing that that money could still be used if the legislature appropriated the money, is that true?”

Haught responded, saying that it was his understanding that the expenditure side of the budget would not be completed until May 1st, but stated “theoretically” that was possible.

Del. Mike Pushkin, D-Kanawha, criticized the legislature for passing a bill that he said places strain on retirees.

“I mentioned the word arrogance earlier in regards to our current legislature, in regards to this super-duper majority,” Pushkin said. “I mentioned arrogance to raise premiums on public employees under the guise of a shell game of giving out a pay raise at the same time, while voting to give themselves a raise, a substantial raise for those in leadership.”

“They built into it cost of living adjustments for those at the top of the legislature, something they could not find it in their hearts to do for retirees for how many years?” he continued. “When’s the last time you got a cost-of-living adjustment if you’re a retiree?”

Pushkin contended that Gov. Jim Justice broke his promise when he said that premiums would not go up.

“When asked if he would raise premiums he said, ‘Not on my watch,’” Pushkin said.

Retired educator John Riddle told the panel that retirees are facing an ever-increasing cost of living.

“Let me tell you something, for 18 years of retirement, if you look at the cost of living, retirees on a fixed income are not in a very good spot,” Riddle said. “And all I’m asking you to do is to continue to allow our retirees to have a place at the table to talk with you.”

Three more public hearings are scheduled this week, including two on Tuesday at 6 p.m. in Morgantown at the Hampton Inn and in Huntington at the Mountain Health Arena. The fourth public hearing is on Wednesday at the Holiday Inn in Martinsburg.

The Finance Board will follow up with a meeting on Thursday, March 30 at 1 p.m. The board will consider comments from the public hearings and adopt the new Plan Year 2024 which will be published in the 2024 Shopper’s Guide.

Visit the PEIA website for more information on the public hearings.

PEIA On Track For Short-Term Funding, Long-Term Fears

A finalized PEIA fiscal plan has no premium increases in 2023 and 2024 for state employees or retirees.

Following a statewide series of public comment sessions, a now finalized PEIA plan has no premium increases in 2023 and 2024 for state employees or retirees. Premiums will go up 9.7 percent for non-state participants.

The agency’s five-year outlook projects zero increases through 2027. But anticipated rising healthcare costs would require nearly $400 million more in public funds to offset shortfalls.

West Virginia Education Association President Dale Lee said the future financial projection is old news that needs new attention.

“I feel like I should go ahead and record my remarks and just punch play every time they have a meeting, because it’s the same remarks for the last two years,” Lee said. “I applaud Gov. Jim Justice, and I truly believe that there won’t be any increases under his watch. After he leaves, we’re facing some dire circumstances.”

Justice has pledged to keep premiums flat while he’s in office. Following the 2018 statewide teacher strike, he established a $100 million reserve fund to cover any rising insurance costs.

But what happens when Justice is out of office?

Lee said concerns over long term funding harken back to a 2019 legislative recommendation from the PEIA task force.

Lee said one current legislative leader supported the recommendation, but has yet to act.

“At the time, Senate President Craig Blair was the Finance Committee Chair and a member of the task force,” Lee said. “He seconded the motion to make this a recommendation that passed. And yet it hasn’t made its way to a committee agenda since 2019.”

Lee said legislation requiring PEIA money to go into the general fund will be proposed in the upcoming regular session.

PEIA Faces Long-Term Funding Challenges

A five year outlook published by the Public Employees Insurance Agency (PEIA) keeps state employee premiums at zero through 2027, but anticipates transferring in more than $375 million in public funds to shore up the program.

At a PEIA Finance Board meeting Thursday, CFO Jason Haught laid out a 2024 draft plan that was approved to go to the next step — public hearings.

The 2024 projected plan does include some deductibles and out-of-pocket adjustments.

Under-performing stock market investments and resuming pandemic-delayed elective medical procedures helped create a $92 million deficit in 2022. In 2018, rising insurance premiums and no pay raises sparked a statewide teachers strike.

Gov. Jim Justice has pledged to keep premiums flat during his terms in office. Following the teacher strike, he established a $100 million reserve fund to cover any rising insurance costs. The PEIA long-term outlook figures use all of that funding for 2023 and 2024, with nothing available after that. The concern is the rising costs going into the next gubernatorial cycle.

PEIA Chairman Mark Scott said the agency plans on resuming funding discussions to cover the long-range cost projections and avoid benefit reductions.

“There are discussions ongoing with the legislature about ways that we might be able to impact these price increases going forward,” Scott said. “We are definitely willing and wanting to listen to ideas from all parties on the ways that we can keep these costs from increasing as high as we estimate.”

The 2024 plan will be presented at a series of statewide public hearings, beginning next week.

W.Va. PEIA Addressing Funding Challenges

After a major financial shortfall, the Public Employees Insurance Agency is working on shoring up its future funding.

After a major financial shortfall, the Public Employees Insurance Agency (PEIA) is working on shoring up its future funding. The agency ended the past fiscal year down $93 million.

West Virginia Education Association President Dale Lee said the shortfall came, in part, from a reduction in projected investment income and an increase in post-pandemic elective surgeries.

“The investment income was less than they projected due to what happened in the stock market,” Lee said. “The number of claims was higher. During the COVID-19 years, people were putting off the elective procedures, and in 2022 people were starting to do those again, so the number of procedures that were being paid for was higher than what they had anticipated.”

Lee said PEIA officials have cost savings measures now in place and believes Gov. Jim Justice will honor his promise to keep PEIA solvent.

“At some point you’re going to have to put money in,” Lee said. “I believe the governor will put the $93 million in so there won’t be any increases for this next year. But where the problem lies is down the road come about 2026.”

Lee said concerns over long term funding go back to a 2019 legislative recommendation from the PEIA task force.

“Put PEIA money into the general fund so that you know that you’re funding it. Provisions that the state shall pay no less than 80 percent of that and the employee shall pay no more than 20 percent,” Lee said. “The cost savings would come under the employee share. It’s a way of ensuring for the long term, the viability of PEIA. At the time, Senate President Craig Blair was the Finance Committee Chair and a member of the task force. He seconded the motion to make this a recommendation that passed. And yet it hasn’t made its way to a committee agenda since 2019.”

PEIA will release its new financial plan at a statewide series of public events in November.