PEIA FY 2019 proposed plan is released
(Updated at 4:30 p.m. on Oct. 27, 2017)
The PEIA Finance Board revealed a proposed fiscal year 2019 plan on Oct. 19, and WVEA has real concerns about the plan and how it will affect active employees and retirees.
WVEA President Dale Lee said at the meeting that salaries are stagnant and benefits continue to erode, which is leading to growing teacher vacancies in the state.
The finance board may vote to have far fewer tiers that determine an employee’s premium.
If PEIA moves from 10 tiers to three tiers, employees in Plan A who earn up to $36,000 would pay $64 for their own monthly premium. A similar employee who earns between $36,001 and $62,500 would pay $94 per month in Plan A, while an employee in Plan A who earns $62,501 or more would pay $147 a month in premiums.
A major change in the plan would require that premiums be paid by the person. For instance, Plan A employees would pay $51 per month for each dependent under age 21, $73 per month for each dependent over 21 and $146 to cover a spouse, according to the proposal.
A family with more than three children under 21 would not be required to pay an additional premium for the fourth or fifth child, but there is no per-dependent premium maximum on children 21 and older.
PEIA also is planning to take total family income into account if an employee’s spouse is covered by PEIA.
This would pose real problems for some of our members.
For instance, an education support professional (cook, aide, bus driver, custodian, etc.) in Plan A who earns an average salary of $27,461, has a spouse who does not work and two children under 21 would pay $936 a year more in family premiums under the proposal.
If the employee’s spouse does work, and earns the same pay, they would pay nearly $1,300 more in premiums for a family plan.
Consider the same situation, but for a teacher in Plan A who earns $45,554 each year. If that is the family’s only income, then their premiums will be almost entirely unchanged. But if the teacher’s spouse earns the same salary and their two children are also covered, they would be paying nearly $650 more each year in premiums.
There are more concerns with factoring in total family income, which is defined as the sum of the spouses’ adjusted gross income.
The money received by a spouse who doesn’t work and receives disability would be included as adjusted gross income, as would the military retirement pay of the spouse or the state employee.
This plan does create winners and losers. That’s plain to see. Some people will be happy with their lower premiums, deductibles and even out-of-pocket maximums.
Crunching the numbers, we see that superintendents making six-figure salaries – who HAVE received recent pay raises – would pay much less for their health insurance next year, while many cooks, bus drivers and young teachers will be paying more.
If the move is made to total family income, PEIA will provide a form to report it.
Further, the proposal would eliminate the employee/employee spouse discount, which, for instance, would negatively impact a husband and wife who are both teachers.
Deductibles and out-of-pocket maximums also would vary based on total family income for employees who cover their spouse.
For instance, a single employee in Plan A who earns $46,000 each year could have a $475 deductible and a $2,525 out-of-pocket maximum, based on current estimates.
But if that employee has a spouse who earns $40,000 a year and both are covered by PEIA, the current estimate for their deductible in Plan A could be $1,300 and their out-of-pocket maximum could be $5,750. (Note: Deductibles in Plan B are nearly double those of Plan A, and out-of-pocket maximums are about $250 more, as well.)
“I’m concerned that we just keep taking more and more,” Lee told the Finance Board.
Pharmacy deductibles will be removed for active employee members in plans A, B and D. But preferred brand drugs which cost members $25 or $30 would require 30 percent co-insurance. That could lead to a $100 maximum cost for a 30-day prescription or a $200 maximum for a 90-day prescription drug.
People who need these drugs are going to be hurt most by this proposal. This includes those participants who are currently taking drugs on the Preferred Brand list or those who may be prescribed one of these drugs in the future.
For someone who is ill and taking multiple drugs on the Preferred Brand list it will represent a significant increase in out-of-pocket costs.
Retirees also could see 2 percent premium increases and similar pharmacy and plan changes as active employees.
They also would see the same pay-by-person premium changes as active employees.
The PEIA Finance Board is expected to vote on the Fiscal Year 2019 plan on December 7. This year, only three in-person public hearings are scheduled for 6 p.m.
| November 6 at the WVU Erickson Alumni Center in Morgantown
| November 7 at the Holiday Inn off Interstate 81 in Martinsburg
| November 14 at the Tamarack in Beckley
| November 15 at the University of Charleston’s ballroom in Charleston.
Initially only the Charleston, Beckley and Morgantown hearings were planned, in addition to teleconference meetings.
Lee spoke against only holding three in-person public hearings, which could limit plan participants’ voices from being heard.
In response, the Finance Board voted to hold the meeting at the Holiday Inn in Martinsburg.
Additionally, there will be one teleconference public hearing on Nov. 13. It is expected that between 200 and 250 people would be able to participate on the call. The toll-free access number to participate is 1-866-206-0240. The participant pin is: 96783409.
Testimony will be allowed during the public hearing, PEIA Director Ted Cheatham said.
WVEA will be giving testimony about the FY 2019 plan during each of the public hearings. Please make your voice heard about these proposals, as well.