PEIA Proposes Smaller-Than-Expected 2% Premium Hike for State Workers, Retirees Held Flat

CHARLESTON, W.Va. — For the teachers, state workers and retirees who keep West Virginia running, here’s some news worth a second cup of coffee: the next round of Public Employees Insurance Agency premium increases is shaping up smaller than a lot of folks had braced for.

At its meeting Thursday afternoon, the PEIA and Retiree Health Benefit Trust Finance Board laid out its proposal for the 2028 plan year, which covers benefits from July 1, 2027, through June 30, 2028. Nothing is final yet. The proposal now heads out to the public for comment before the board votes.

What it means for state employees

For members of the State Fund, which covers state employees, teachers and other school workers, PEIA is proposing a 2% aggregate premium increase for both employees and employers. The plan also includes 1% in benefit modifications and a $2.50 increase in the administrative fee that employers pay. The family-tier spousal surcharge would stay right where it is.

PEIA Director Brent Wolfingbarger told the board the agency took stronger-than-expected results into account. PEIA finished fiscal year 2026 well ahead of plan, he said, mostly because medical and prescription drug claims came in lower than forecast.

That drew some relief from the people who represent school employees. Education West Virginia co-president Dale Lee said at the meeting that he was pleasantly surprised the increase came in lower than last year’s projection, and he praised the board for leaving the spousal surcharge alone.

Good news for retirees

Retirees get a break this time around. Under the proposal, their premiums would stay flat for fiscal 2028. To make that work, the plan lowers the payments the active fund sends to the retiree trust and sets aside $187 million in investment gains as a stabilization reserve.

A tougher picture for local governments

Not everybody is getting off as easy. The Non-State Fund, which covers the cities, counties and other local agencies that buy into PEIA, would see a 4% aggregate premium increase for most plans, plus 2% in benefit modifications. The Gold high-deductible health plan in that fund is facing a much steeper proposed jump of 24%.

PEIA says that plan has been struggling. Its actuaries project the Non-State Fund’s medical and prescription costs will run about $10 million more than the premiums it brings in during fiscal 2027, mainly because of the Gold high-deductible plan. PEIA is also moving ahead with a standard that local employers taking part must have at least half of their employees enrolled in a PEIA health plan by next June 30.

Have your say

Before anything is locked in, the Finance Board will hold six public hearings across the state. At each one, registration and speaker sign-in start at 5:30 p.m. and the hearing begins at 6 p.m.:

• Nov. 9 — Morgantown, Hampton Inn & Suites University Town Centre
• Nov. 10 — Beckley, Beckley-Raleigh Convention Center
• Nov. 12 — Virtual, online
• Nov. 16 — Shepherdstown, Shepherd University Student Center
• Nov. 17 — Charleston, Capitol Complex Building 3
• Nov. 19 — Wheeling, River City Restaurant

PEIA says the full proposed plan changes will be posted on its website by Nov. 1. If your family’s health coverage runs through PEIA, these hearings are your chance to be heard before the board makes its final call.