WVPA Executive Director Richard Stevens attended yesterday’s Public Employee Insurance Agency Finance Board meeting when the 2019-20 benefit plan was approved with no premium increases or cuts in benefits.
The Board’s action follows Governor Jim Justice’s call for maintaining the current benefits without state workers paying any greater premiums.
The plan adds an appeals process for insureds who require medications that are on the Tier 3 nonpreferred brand name list, which carries a 75 percent copayment up to the $1,750 annual out-of-pocket maximum for prescription drugs. “This will help patients at the prescription counter,” said Stevens.
Responding to hospitals’ concerns, the Board did roll back a proposal to eliminate financial penalties for insurers who seek care from out-of-state providers to apply only to counties bordering West Virginia. Currently, insureds pay greater costs when obtaining services outside the State. The Board’s move is expected to increase cost by $6 million a year.