Proposed PEIA Plan Changes, Hearing Schedule and Talking Points

On November 6, 2008, the PEIA Finance Board approved a proposed plan to
present at public hearings across West Virginia beginning November 12th in
Wheeling. The plan includes increases in premiums, co-payments and out-of-pocket
maximums and would take effect July 1, 2009. Note that the public hearings
begin this week. AFSCME WV Local Officers will attend the hearings and it is
important that you attend as well.
Here is a brief summary of the plan changes:
Premium Increases:

Active employees will increase 9%.
Retirees will increase 11%.

Prescription Co-payment Increases:

Active employees:
ƒ Current – 5/15/50
ƒ Proposed - 5/25/50
Nexium, Prevacid, Aciphex, Clarinex, Xyzal no longer
Implementation of new drug formulary;
Some drugs will be removed from the $50 level;
ƒ “Tier Two” to increase from $15 to $20.

Major Medical Drug Plan Changes for PPB Plan A:
Out-of-pocket maximum for family coverage (employee and children,
family, family with employee spouse) to increase to 150% of the single
coverage (50% increase for all policies with more than one covered
ƒ e.g., out of pocket maximum will change from $1,100 to $1,650
for those making $20,001 to $30,000;
ƒ e.g., out of pocket maximum will change from $1,500 to $2,250
for those making $36,001-$42,000;
ƒ e.g., out of pocket maximum will increase change from $1750
to $2,265 for those making between $42,001 to $50,000;
For active employees
Increase in “in-network” office visits co-payments:
Current – 10/15/20
Proposed – 10/20/25

ƒ For Retirees “in-network” office co-payments :
Current - $10/20
Proposed - $10/$25
Additional co-payments for other services.
Co-payments for network providers outside of WV will increase from an
80/20 co-payment to a 70/30 co-payment (this impacts those who reside in our
border counties);

Talking Points
The 9% premium increases come at a time when state employees are only
receiving salary increases of 3%;
The 11% premium increase will cripple those retirees who are on fixed incomes;
With our state enjoying a budget surplus, there is no need to implement these measures.
The proposed changes will have serious consequences on the lives of thousands of state
employees, both active and retired;
The higher co-payments will hurt disproportionately those who reside in border counties;
This will make it even more difficult for the state to attract and retain quality personnel;
With the cost of gas and other basic necessities dramatically increasing, employees simply
can’t afford the increases in premiums and benefits as proposed.
Public Hearing Schedule
Customer Service: 4:00 - 6:00
Registration: 5:30 – 6:00
Public Hearing: 6:00 – 8:00
Ramada Inn, 20 Scott Avenue, Morgantown, WV Holiday Inn, 301 Fox Croft Avenue, Martinsburg, WV Tamarack Theatre, One Tamarack Park, Beckley, WV Civic Center, Little Theater, 200 Civic Center Drive, Charleston, West Virginia Marshall University Medical School, Harless Auditorium, 1600 Medical Center Drive, Huntington, WV

Source: http://www.afscmewv.org/news_and_updates/2008/11_12_peia_plan.pdf

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