PEIA Conducts Public Hearings to Discuss Proposed Health Insurance Changes for the Next Plan Year

health insurance plans, including premium increases and a new spousal surcharge. public hearings are scheduled across the state.">

November 2, 2025

CHARLESTON, W.Va. – West Virginia state employees will soon have the opportunity to provide feedback on proposed alterations to their health insurance coverage through the Public employees Insurance Agency (PEIA). Public forums are scheduled to begin Monday, offering state workers a platform to voice their concerns and suggestions.

Upcoming Public Hearings

The PEIA Finance board is embarking on a series of public meetings, with two sessions planned each week over the next three weeks. The initial hearing is slated for monday evening at the Highlands Event Center in Wheeling. Subsequent meetings will be held at the Beckley-Raleigh County Convention Center on november 6th, the Holiday Inn in Martinsburg on November 10th, the Culture Center in Charleston on November 13th, and the Mountainlair Student Union in Morgantown on November 17th. A virtual town hall meeting will conclude the series on November 20th.

Registration for all events will commence at 5:30 p.m., with the public hearings officially beginning at 6:00 p.m.

Proposed Changes to PEIA Plans

Currently, PEIA is considering a 3% aggregate premium increase affecting both employees and employers. Additionally, a $200 monthly surcharge is proposed for employees with spouses also covered under the plan. These changes, if implemented, are scheduled to take effect on July 1st of the coming year.

This proposed 3% increase represents a moderation compared to previous years, where increases reached as high as 14% for the state fund and 16% for local government plans, with retirees facing a 12% rise. Last year also saw an average deductible increase of 40%,translating to an additional $300 or more out-of-pocket for many.

Year	Premium Increase (State Fund)	Deductible Increase (Average)
2024	14%	40% ($300+)
2025 (Proposed)	3%	None Proposed

Union Leaders Advocate for Employee Needs

Dale Lee, Co-President of Education West Virginia, emphasized the importance of clear communication regarding the available plan options. The newly formed union, representing former members of the WVEA and AFT-West Virginia, intends to provide extensive explanations to its members. Lee suggested that younger and healthier workers might benefit from selecting Plan D, a lower-premium, high-deductible option that is frequently enough overlooked.

“Many employees are often automatically enrolled in Plan A, but it’s crucial to explore all available plans to determine the most cost-effective choice for their individual needs,” Lee stated.

Elaine Harris, a representative for state workers, expressed hope for substantive negotiations on the future of PEIA. While acknowledging the quality of the current coverage, Harris highlighted the financial strain on state employees.

“PEIA provides good coverage; the challenge lies in the increasing costs faced by our dedicated state workforce,” Harris explained.

Lee also aims to modify the proposed spousal surcharge, advocating for a tiered system based on employee income rather than a uniform $200 monthly fee. He indicated that legislative action would be required to enact this change and plans to lobby for it during the upcoming legislative session.

Moreover,Harris voiced concerns about the rising premiums affecting retired state workers and applauded the finance Board’s proposal to increase funding for premium assistance programs.

Did You Know? According to the Kaiser Family Foundation, employer-sponsored health insurance premiums have risen an average of 5% annually over the past decade.

pro Tip: Carefully review all plan options and compare costs, deductibles, and coverage levels before making a decision during open enrollment.

Understanding Health Insurance Options

Navigating health insurance plans can be complex. It’s vital to understand the differences between Health Maintenance Organizations (HMOs), Preferred Provider Organizations (PPOs), and high-Deductible Health Plans (HDHPs). Each plan type offers varying levels of flexibility,cost-sharing,and access to healthcare providers. Resources like Healthcare.gov can provide detailed explanations of these options.

Consider your individual healthcare needs and budget when selecting a plan. Factors such as anticipated medical expenses, preferred doctors, and prescription coverage should all be taken into account.

Frequently Asked questions About PEIA

• What is PEIA? PEIA stands for the Public Employees Insurance Agency,and it provides health insurance coverage to West Virginia state employees,retirees,and their families.
• What is the proposed premium increase for PEIA plans? PEIA is proposing a 3% aggregate premium increase for both employees and employers.
• What is the proposed spousal surcharge? A $200 monthly surcharge is proposed for employees with spouses covered under the same plan.
• When will the proposed changes take effect? If approved, the changes will take effect on July 1st.
• Where can I find more data about PEIA plans? Information can be found at the PEIA website and at the upcoming public hearings.
• What is a high-deductible health plan? A high-deductible health plan generally has lower monthly premiums but requires a higher out-of-pocket expense before coverage kicks in.
• How can I influence the decision-making process regarding PEIA changes? Attend the public hearings and share your concerns with the PEIA Finance Board.

What are your biggest concerns regarding health insurance costs? Do you think the proposed changes will adequately address the needs of state employees?

What specific adjustments to deductibles were discussed for CDHP participants?

Understanding the Proposed Changes to PEIA Health Plans

The Public Employees Insurance Agency (PEIA) in West Virginia recently held a series of public hearings to gather feedback on proposed changes to health insurance plans for the upcoming plan year. These hearings are a crucial part of the process, allowing state employees, retirees, and other stakeholders to voice their opinions on potential adjustments to coverage, premiums, and benefits. Understanding these proposed changes is vital for anyone covered by PEIA insurance. This article breaks down the key areas of discussion and what they mean for you.

Key Areas of Proposed Changes

Several key areas were under review during the PEIA public hearings.These include:

* Premium Adjustments: Discussions centered around potential increases to monthly premiums for various plan options. Factors influencing these adjustments include rising healthcare costs, prescription drug prices, and overall plan utilization.

* Benefit Modifications: Proposed changes to benefits included adjustments to deductibles, co-pays, and out-of-pocket maximums. Specific services, like mental health coverage and specialized medical treatments, were also examined.

* Network Changes: PEIA considered modifications to provider networks, potentially impacting access to certain doctors, hospitals, and specialists. This is a meaningful concern for many beneficiaries.

* Prescription Drug Coverage: Updates to the formulary (list of covered drugs) were discussed, including potential changes to tier structures and prior authorization requirements. This directly affects medication costs for plan members.

* Plan Options: The possibility of adding or removing specific plan options was also on the table, aiming to provide a wider range of choices or streamline the available plans.

Impact on Different PEIA Plan Types

The proposed changes don’t impact all PEIA plan types equally. Here’s a breakdown:

* PPO Plans: Potential increases in out-of-pocket costs and adjustments to provider networks were major concerns for those enrolled in Preferred Provider Organization (PPO) plans.

* HMO Plans: Health Maintenance Organization (HMO) plans were also subject to scrutiny regarding premium adjustments and potential limitations on specialist access.

* Consumer-Driven Health Plans (CDHP): Changes to Health Savings Account (HSA) contribution limits and adjustments to deductible amounts were discussed for CDHP participants.

* Medicare-Eligible Retirees: Proposed changes to supplemental Medicare plans were reviewed, focusing on prescription drug coverage and cost-sharing arrangements.

How Public Hearings Work & Why Your Voice Matters

PEIA’s public hearings are designed to be obvious and inclusive.The process typically involves:

1. Presentation of Proposed changes: PEIA officials present a detailed overview of the proposed changes to the health insurance plans.
2. Public Comment Period: Attendees are given the possibility to share their feedback, concerns, and suggestions. This can be done verbally during the hearing or in writing.
3. Review and Consideration of Feedback: PEIA officials review all submitted feedback and consider it when making final decisions about the plan changes.

Your participation is crucial. Providing feedback helps PEIA understand the real-world impact of proposed changes and make informed decisions that best serve the needs of its members. Active engagement ensures that your concerns are heard and addressed.

Resources for Staying Informed

Staying up-to-date on PEIA changes is essential. Here are some valuable resources:

* PEIA Website: https://www.peia.wv.gov/ – The official PEIA website provides detailed data about plans, benefits, and upcoming changes.

* PEIA Newsletters: Sign up for PEIA newsletters to recieve regular updates on important announcements and deadlines.

* PEIA Customer Service: Contact PEIA customer service directly with any questions or concerns. Their contact information is available on the website.

* Union Representatives: If you are a member of a union, your union representative can provide valuable insights and advocacy support.

* **West Virginia State Legislature