CHARLESTON, W.Va. --- State and public school employees covered by Public Employees Insurance Agency plans will not see premium increases next year - but probably will see new or increased co-payments for prescription drugs and for a variety of medical services, under a tentative 2012-13 plan presented Tuesday to the PEIA Finance Board.
"We've tried to keep the premiums down as low as we can," PEIA executive director Ted Cheatham said of the proposed coverage plan.
Overall, the proposed plan shifts about $32.9 million of costs from PEIA to insurees, primarily through new or increased co-pays.
That includes a proposed increase in co-pays for prescription drugs, to provide a cost-shift of about $20.4 million.
The proposal includes raising the co-pay for generic prescription drugs from $5 to $8, brand-name prescriptions on the preferred drug list from $15 to $50, brand-name non-preferred drugs from $50 to $85, and specialty drugs from $50 to $100.
Overall, the higher co-pays would work out to an average cost of about $432 a year per policyholder, or about $36 a month, Cheatham said.
However, unlike premium increases, co-pays are directly tied to usage of medical services and prescription drugs.
"It's who uses the services who pays," Cheatham said.
The plan also proposes savings of just under $1 million a year by eliminating PEIA coverage for massage therapy, and for acupuncture treatments.