Delegate Cindy Frich, R-Monongalia, Morgantown
Let’s talk about the Public Employees Insurance Agency (PEIA) because it is important in Monongalia County.
Teachers, employees of county school boards, have 80 percent of their health insurance premiums paid by West Virginia taxpayers.
Employees pay 20 percent of their premiums and pay co-pays and deductibles. The state also provides PEIA coverage for state employees. This large group gives PEIA buying power to reimburse medical providers at lower rates than Medicaid and Medicare, bolstering PEIA efficiencies.
PEIA is funded by the Legislature but insurance decisions are made by the PEIA Finance Board, whose members are appointed by the governor. During the final years of Democrats’ legislative majorities, the board maintained PEIA by spending down reserves without action or additional funding by lawmakers.
For the past few years, the Republican-led Legislature dramatically increased funding for PEIA, creating new line items within budget bills in order to protect retirees and avoid increasing the 20 percent premium requirement for employees.
The board’s new wellness plan (Go365) was quite punishing, and the new policy of including spousal income to determine premiums was an intrusion of privacy and dramatically increased premiums for some.
The Legislature and governor agreed to ask the board to terminate Go365 and freeze PEIA to avoid changes. Then, the House of Delegates passed a bill that I co-sponsored, which funded a PEIA freeze. Next, we passed a resolution requesting the board freeze PEIA.
The board froze PEIA prior to the teacher walkout.
Despite returning to the old income tiers, Republican legislators had been concerned that historic pay raises would bump some employees into higher premium/deductible brackets.
The governor recently recommended the board adjust income brackets so pay raises don’t negate insurance benefits. Perhaps the PEIA task force might consider whether the unique practice of basing insurance plans on income is wise considering insurance is usually based upon actuarial risk.