CHARLESTON - With the help of a $105 million cash infusion from the West Virginia Legislature, the PEIA Finance Board on Thursday approved preliminary 2020-21 benefit plans with no premium increases or benefits cuts for active employees and retirees.
"We're proposing to go out (to public hearings) without any rate increases at all," PEIA executive director Ted Cheatham told the board.
For employees of cities, counties and governmental agencies with PEIA coverage, the preliminary plan is even better, calling for a two-year phase in of premium cuts.
"Our intention is to put in some sort of rate decrease," Cheatham said.
The good news was made possible by a strong financial performance for the plan in the 2018-19 budget year, which saw investment earnings exceed projections by nearly $60 million, while medical and prescription drug claims came in nearly $14 million less than expected.
PEIA also has the $105 million cushion, the Justice administration and Legislature's response to state teachers' demands to find a "fix" for a PEIA plan that in recent years has continuously had to raise premiums or cut benefits to stay solvent.
Cheatham said he won't know until more financial data comes in later this year just how far PEIA will need to dip into that reserve fund to avoid premium hikes.
"We're not sure at this point," he said after the meeting. "It's going to be something less than $40 million, I'm sure."
He said if the plan's financials stay strong, PEIA may not need to use any of the reserve fund for the 2020-21 plan year, which begins next July 1.
While there will be no benefits cuts in 2020-21, the plan proposes a few tweaks in benefits, including offering two free chiropractic visits for treatment of back pain.
Cheatham said an Aetna insurance study found a significant reduction in the need for back surgery for patients who underwent chiropractic treatment for back pain.
The proposed benefit plans will go out to public hearings around the state in November, with the Finance Board scheduled to meet Dec. 5 to formally approve the plans.
Meanwhile, Cheatham said since there are no changes in premiums planned in 2020-21, there will be no need to adjust premium rate tiers next year.
n Cheatham said Charleston Area Medical Center has notified the Health Plan of the Ohio Valley that it plans to terminate its contract with the health insurer Dec. 31, but said CAMC will honor coverage for PEIA members who are covered through the Health Plan's Health Maintenance Organization through June 30, 2020.
That will give PEIA insurees time to change plans during the open enrollment period next spring if CAMC and the Health Plan fail to reach a contractual agreement.
"My hope would be that these two entities will maintain their relationship," said Administration Secretary Allan McVey, who serves as chairman of the Finance Board. "If not, we have to be prepared for that."
n PEIA will host an Obesity Summit on Oct. 24. Cheatham said PEIA wants to hear from health care providers on ways to address the state's obesity problem, and to evaluate current wellness programs offered by PEIA.
"Let's work on obesity," said Cheatham, noting that West Virginia leads the nation in percentage of overweight adults.