CHARLESTON — The PEIA Task Force has two proposals to provide more certainty and flexibility for finances.
The recommendations that were approved Monday would now need to go to the Legislature for action.
“If you want to fix PEIA, this is the way to do it,” said task force member Perry Bryant, founder of West Virginians for Affordable Healthcare.
“We can take a great deal of pride if we can go out and do this.”
The first proposal gives the Legislature an annual deadline for dealing with PEIA’s finances.
That’s meant to provide certainty for the Public Employees Insurance Agency as it moves forward each year with plans for recipients.
What PEIA would like to avoid is a situation where administrators think there’s a certain amount of money available, only to have the Legislature unexpectedly change it or delay settling on an amount.
The current recommendation says the Legislature must set an estimated available revenue figure for PEIA by the 16th day after the annual legislative session begins. It’s possible that deadline could change to 30 days after the start of the session.
The other recommendation deals with the 80-20 cost formula for PEIA.
The Task Force is trying to avoid unintended consequences where more state money is dedicated to PEIA and automatically raises premium costs for beneficiaries because of the hard-and-fast 80-20 rule.
Under the proposal:
The Legislature’s share would be at least 80 percent and the employee’s share would be no more than 20 percent.
The mix for what constitute’s the employee’s share could be more flexible too. Right now, the 20 percent composed of premiums.
The potential change says the PEIA Finance Board could switch the employees’ share to include increases in premiums or also deductibles, copayments, co-insurances and wellness initiatives.
So the 20 percent could come from a broader set of overall employee costs.
Finally, there’s an element of greater flexibility for the state share, too.
In a form of budgetary smoothing, the Legislature may appropriate more than 80 percent one year and follow that up by appropriating a lower amount the following year.
The allocation may not go below 70 percent.
PEIA Director Ted Cheatham was pleased by the proposals.
“This solution does provide a long-term funding solution for PEIA,” Cheatham said.
The PEIA Task Force was established after last year’s statewide teachers strike. Teachers had complained of spiraling out-of-pocket costs.
The Task Force has met over the past half-year, establishing some earlier recommendations. One of those had to do with providing access to healthcare across West Virginia’s border.
Task Force members have said their work isn’t done, but it’s also not clear when they might meet again.
“We’ll announce another meeting at a certain point,” Justice administration Chief of Staff Mike Hall told the group today.
