CHARLESTON, W.Va. -- For a third straight year, state and public school employees covered by the Public Employees Insurance Agency will see no increases in their health insurance premiums.
The PEIA Finance Board gave tentative approval Thursday to a 2014-15 plan with no premium hikes, and only minor changes in two categories of co-pays. The proposal also includes no premium increases for PEIA retiree coverage.
The premium freeze, which will be voted on by Finance Board members in December following a series of public hearings around the state, was made possible by lower-than-projected medical and prescription drug expenses and strong investment earnings in the 2012-13 budget year, PEIA Executive Director Ted Cheatham said.
"Last year was a tremendous year. I've never seen anything like that," Cheatham said Thursday.
For active employees, medical claims costs dropped 2.7 percent and prescription drug expenditures fell 4.2 percent.
That's in sharp contrast to national trends of 4 percent annual increases in medical costs, he noted.
Cheatham said the weak economy may have led insurees to put off elective procedures, or make fewer visits to the doctor.
Also, he noted that in the first week of July 2012, following the massive derecho storm, medical claims dropped $6 million compared to the same week in 2011.
"People didn't go see the doctor. They were worried about other things," he said.
Likewise, Cheatham said an aggressive program to encourage PEIA insurees to use generic equivalents instead of expensive brand-name prescription drugs appears to be working, with generics accounting for more than 80 percent of all PEIA prescriptions filled.
The proposed 2014-15 plan will feature only two minor changes in co-pays, with one intended to encourage PEIA insurees in border counties to use in-state providers.
The plan will add a $25 out-of-state co-pay for insurees who go out-of-state to have CT or MRI scans, dialysis, outpatient surgery, certain endoscopic procedures, or to make durable medical equipment purchases.
Cheatham noted that those procedures are considerably more expensive at out-of-state facilities than the rates PEIA has negotiated with in-state providers.