Monday, December 8, 2025
Monday, December 8, 2025

Interim Report: Joint Committee on Insurance and PEIA

The Joint Committee on Insurance and PEIA heard the 2027 PEIA proposals.
Due to no increases from 2018 to 2022, in the last year, PEIA had to raise premiums at a high rate. To prevent this, they will continue to raise premiums slowly as health care costs rise. The spousal surcharge will increase, which was a point of contention with the public. PEIA said they’ve done everything to keep retiree costs down.
Employees under the state fund will see the following changes:
  • A 3% aggregate premium increase for both employees and employers
  • Spousal surcharge increase of $200 for a total of $550
  • Plan D will be converted to a lower-value plan to offer options.
    • Plan D premiums will decrease 34%
    • Plan D coinsurance will decrease from 80% to 75%
    • Plan D deductibles will increase by 425%
    • Plan D’s max out-of-pocket will increase by 55%
    • Plan D will be given a one-time $500 employer-funded HSA or HRA from the employer.
  • PEIA PPB plans will be renamed
    • Plan A = PPB Gold
    • Plan C = PPB Gold high-deductible plan
    • Plan B = PPB Silver
    • Plan D = PPB WV Bronze high-deductible plan
Employees under the non-state fund will see the following changes:
  • A 3% aggregate premium increase for both employees and employers
  • Plan D will be converted to a lower-value plan to offer options.
    • Plan D premiums will decrease 34%
    • Plan D coinsurance will decrease from 80% to 75%
    • Plan D deductibles will increase by 425%
    • Plan D’s max out-of-pocket will increase by 55%
  • Employers need to have 50% participation.
  • Plan C – increased premiums, deductibles, and max out of pocket of 5%
  • Adjust non-state coverage tiers, deductibles, and MOOP and/or premium by 5%
    • The employee with children plan will decrease 5%
    • Family tiers increase 5% to cover higher costs.
Those under the retiree fund will see the following changes.
  • Non-Medicare premium increase 3%
  • Medicare premium increase 3%
  • Increase retiree Paygo from $10 million to $55 million.
  • Designating $30 mil of FY25 investment funds as a retiree premium stabilization reserve
Additionally, a five-year plan was presented.

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