A bill that would change some aspects of the Public Employees Insurance Agency is under the microscope.
“I’ll tell you, this is a PEIA overhaul bill,” said Sen. Ben Queen, R-Harrison, chair of a Finance subcommittee examining the legislation. “I mean, this is a big, big bill. It’s 60 pages long. We’re making sure that the corrections are needed.”
That subcommittee discussed the bill once on Tuesday afternoon and is planning to meet again later this week before it advances to the full Finance Committee. The Senate Health Committee already discussed a version of the PEIA bill.
“I think we’re getting there. We have some changes to go,” Queen said.
Senate Bill 268 makes a range of changes to PEIA, growing out of concern that the agency faces growing financial stress. The Finance subcommittee dealt with a version of the bill that is different from the version originally introduced, and there could be more changes still ahead.
Some aspects of the bill spell out the fiduciary responsibilities of the members of PEIA’s finance board. It has a requirement for the director to provide a number of people covered and a five-year fiscal analysis of the cost of covering claims. There’s guidance for the PEIA finance board to base its conclusions on an 80-20 employer and employee match.
There’s an actuarial study to address the financial solvency of the plan.
“What I think we’re trying to dive into is how are we going to make the PEIA Finance Board as flexible as possible,” Queen said after Tuesday’s meeting.
“Sometimes we give so much rules and regs from the state legislative standpoint that the PEIA board can’t make their decisions their own. When it’s so dire every year on us bailing the plan out, we need to make sure we’re on a solvency plan moving forward.”
Another component would improve reimbursements to medical providers to 110% of what Medicare pays. That issue became a frontburner matter when Wheeling Hospital announced it could no longer afford the state’s low reimbursement rate. After Wheeling Hospital said it would no longer take patients covered by PEIA, concern arose over whether other hospitals would follow suit.
The Senate already passed a bill reflecting the reimbursement rate for providers, but it’s reflected in this broader bill, too.
There is some emerging criticism of the PEIA bill.
Representatives from the West Virginia Deputy Sheriff’s Association, West Virginia State Fraternal Order Police, Professional Firefighters of West Virginia and the West Virginia State Lodge Fraternal Order Police expressed their concerns over spousal coverage and rising premium costs at a Kanawha County Commission meeting Tuesday morning.
Queen said the bill would not remove spousal coverage, but does include a buy-in for spouses who are not covered by PEIA for their own employment.
“We are not kicking anyone off,” Queen said. “What we’re doing is allowing those folks who have insurance elsewhere to still buy in for PEIA coverage.”
There’s plenty to scrutinize in the bill, said AFL-CIO President Josh Sword. He said he’s trying to keep an eye on everything, noting that changes to the insurance could affect thousands of people.
“It’s a comprehensive bill that addresses a lot of different things and areas within PEIA,” Sword said. “If you’re a retiree right now on PEIA, I’d be really nervous. If you’re a policeman or a firefighter that works for a city or a county that opts in to PEIA, I’d be really worried right now.
“If you’re on PEIA and married and your spouse has access to healthcare through his or her employment, regardless of what that healthcare may look like, I’d be worried. And that’s just a few of the things we’re concerned about.”
Sword, who used to serve on the PEIA Finance Board, said changing state code to reflect greater responsibility could be a significant point.
“It appears to me that there’s an addition of real and legitimate fiduciary liability that’s placed on each board member,” he said. “I’ll be honest with you. I’m not sure who’s going to be interested in serving in that capacity with that kind of liability.”
Sword said it doesn’t assure him much that the bill is being considered several times in committee.
“Maybe there will be positive changes along the way,” he said, “but there are so many provisions in this bill to be concerned about that it doesn’t matter what they do. It’s still going to have some real problems, real concerns.”
