2010 PEIA Proposed Plan & Talking Points
The PEIA Finance Board met on Thursday, October 22, 2009, and adopted a preliminary plan (effective July 1, 2010). The proposed plan represents cost-shifting at its worst and will create severe economic hardships for many PEIA plan participants if enacted. Some provisions of the plan may constitute a violation of our constitutional rights. AFT-WV will be present at all the public hearings to make our voices heard and may be pursuing legal avenues to prevent some of the PEIA Finance Board’s proposals from being enacted if they are ultimately adopted by the Board .
Their proposal will be presented at public hearings (see below) for your comments and includes the following:
I. Premium and out-of-pocket increases:
* A 4% increase in premiums for both employees and employers;
* An increase in deductibles:
* Either $25.00 or $50.00 for active employees;
* $25.00 for retirees;
* An increase in the maximum out-of-pocket costs for family plans – the amount will be equal to double the rate for a single plan. Your out-of-pocket maximum depends on your employment status, salary, where you receive your services, whether your provider is in network and whether you have prior approval.
* For example, a teacher making $40,000, their out-of-pocket maximum for the family plan moves from $1,500 to $3,000.
* For example, a school service employee making $22,000, their out-of-pocket maximum for the family plan moves from $1,100 to $2,200.
II. Benefit reductions:
* A change in the prescription drug formulary;
* Many drugs will be moved to a higher tier thereby resulting in higher costs.
* The creation of a new WV plan (this will be optional) that will limit employees to receiving care in West Virginia. If there is a need for specialty care, plan participants will have access to limited care and services at the Cleveland Clinic and Duke University.
III. As well as these potential changes:
* A requirement that all employees will have to undergo blood work and other testing.
* Failure to undergo the blood test will result in an increase in premiums.
* A requirement that employees sign an affidavit that they have a living will on file.
* Public employee’s spouses, who have access to health care through employer but choose a PEIA family plan, will have to pay a higher premium.
The only “good news” is that the lifetime cap on benefits is increased from $1 million to $1.5 million.
These are only proposals and they will be the subject of the public hearings. The public hearings are as follows (registration at 5:30, hearing starts at 6:00 pm).
Monday, Nov. 9, 2009 - Civic Center, Little Theater, Charleston
Tuesday, Nov. 10, 2009 - Tamarack Theatre, Beckley
Monday, Nov. 16, 2009 - Holiday Inn, 301 Fox Croft Ave., Martinsburg
Tuesday, Nov. 17, 2009 - Ramada Inn, 20 Scott Ave.
Morgantown
Wednesday, Nov. 18, 2009 - West Virginia Northern Community College, Wheeling
Thursday, Nov. 19, 2009 - Marshall University Medical School, Harless Auditorium, Huntington
Talking Points
* In light of the PEIA Finance Board’s recent decision to eliminate the retiree subsidy for new hires, which will free up billions and billions of state dollars, why is it necessary for the Board to cut our benefits?
* The actuary hired by AFT-WV demonstrated that the OPEB liability is only $3.2 billion, not the $7.8 billion claimed by PEIA. If we can’t trust PEIA’s figures as they relate to the OPEB liability, how can we trust PEIA’s assessment that premiums must be increased and benefits must be reduced to make the plan solvent?
* Is it constitutional for the PEIA Finance Board to:
* Require employees to complete a living will?
* Require employees to complete blood work tests?
* Is it fair to penalize family plan participants for choosing PEIA for coverage over a spouse’s employer offered plan?
* In many cases, the spouse’s employer offered plan may be inferior than the one offered by PEIA.
* Given that we have not had a salary increase since 2008 and since the Governor has already stated that a raise is not in the near future, is it fair to increase premiums for the second year in a row?
* A doubling of the out-of-pocket maximum for family plan participants is an outrageous example of cost-shifting from the employer to the employee.
AFT-WV urges you to attend the public hearing in your area. In addition to expressing our outrage over these Draconian proposals, AFT-WV may pursue legal action to stop these attacks on our health care depending upon the Board’s ultimate action.
