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PEIA takes another troubling proposal out to public hearings

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PEIA board takes another troubling proposal out to public hearings
By WVEA Communications staff

Active state employees could face $25 million in benefit cuts and retirees face about $17 million in cuts to PEIA in the coming year.

The PEIA Finance Board voted Thursday to take a draft of a fiscal year 2018 plan out on public comment next month.

This is another unacceptable proposal that solely burdens employees, retirees and their families with the rising cost of health care. Please plan to attend a public hearing near you again and voice your opposition to this latest proposal.     

For active state employees and non-Medicare retirees, deductibles could increase by hundreds of dollars and out-of-pocket costs by thousands of dollars for people in Plan A, B or D. PEIA Chief Financial Officer Jason Haught said the increases could be similar to what was proposed last year under the proposed draconian plan, which wasn’t implemented.

Those increases were a $500 deductible increase for employees only and a $1,000 increase for family coverage. Last year out-of-pocket maximums were proposed to increase by $1,500 for an employee-only plan and $3,000 for a family plan.   

Medicare retirees face increases to deductibles, out-of-pocket costs, emergency room copayments, outpatient surgery copayments, pharmacy deductibles and pharmacy out-of-pocket maximums. The exact proposed increases were not released on Thursday.

Some of the other proposed changes for active employees and non-Medicare retirees are:

| Increases in percentage of patient costs for services that require coinsurance, particularly when the medical services are received out of state.

| Mandatory 90-day prescription fills for maintenance drugs, such as blood pressure medication. A couple concerns about this is that the upfront copay cost will be more for a 90-day prescription than it would for a 30-day prescription. Also, PEIA Director Ted Cheatham acknowledged that some pharmacies in the state only want to let patients fill 30-day prescriptions.    

| Basing an employee’s premiums on total family income if the employee’s spouse or entire family is also receiving PEIA coverage. As proposed last year, there would be winners and losers who would either pay more or less in premiums – depending on the family’s total income.

| For people on Plans A, B and D, an increase in out-of-pocket prescription drug maximums from $1,750 to $2,500 for employee-only coverage and from $3,500 to $5,000 for employee/child and family coverages. 

| Requiring more in coinsurance (30%) for people who have to go through substance abuse treatment a second time, and 50% in coinsurance for people who attempt substance abuse treatment three or more times.      

| Increasing the patient’s cost of a “preferred brand” prescription drug from $25 or $30 to 30% or 35% of the total cost of the drug. So if a prescription drug’s total cost is $600 then the patient’s responsibility could be near or more than $200, depending on their health plan. 

| Increasing specialty drug copayments from $50/$100 to $100/$150.          

We will keep you up to date as we receive more details about the proposals that are going out on public comment.

Last year’s outcry at the six statewide public hearings made a difference in how the governor and Legislature reacted to the PEIA funding shortfall.

Of the six public hearings, the first will be at Big Sandy Arena in Huntington on Wednesday, Nov. 9.

The other public hearings are:

| Thursday, Nov. 10 at the Tamarack’s Ballroom A in Beckley

| Monday, Nov. 14 at Holiday Inn, 301 Fox Croft Ave., Martinsburg

| Tuesday, Nov. 15 at WVU’s Erickson Alumni Center, One Alumni Drive, in Morgantown

| Wednesday, Nov. 16 at WV Northern Community College’s Auditorium, 1704 Market Street, in Wheeling

| Thursday, Nov. 17 at the University of Charleston Ballroom in Charleston  

All the public hearings run from 6 p.m. to 8 p.m. with registration and customer service running from 5 p.m. to 6 p.m.