PEIA UPDATE: PEIA Plan Year 2028 Proposal Released, Public Hearings Scheduled

Education WV Co-President Dale Lee was the only employee representative in attendance and spoke before the Board. Lee presented the union’s proposed language to create salary tiers for the spousal surcharge, so employees who make less would have a lower spousal surcharge than high earners. He also spoke to the Board, stating that any premium increase, even one smaller than we have seen in recent years, calls for a salary increase.

Premium increases

Active employees
Depending on their plan type and salary tier, active employees will see premium increases ranging from approximately $3 to $25 per month. This amounts to an aggregate 2%, but actual increases will vary by participant. This is surprising compared to health insurance premium increases range from 9 to 11% nationwide.

There is no proposed increase in the spousal surcharge.

There will be an approximate 1% change in some benefits, details of these changes were not available at the meeting but will be released soon.

Retirees
There is no proposed premium increase for retirees. This will be for the retiree plan year beginning in January 2028. It is important to remember that retiree plans operate on a calendar year, whereas the plan for active employees operates on a fiscal year, and the 3% premium increase for retirees that was adopted last year will take effect in January 2027.

Why were the premium increases lower than expected this year?
This year’s expected premium increases are lower than previously projected due to several factors including:

• Positive investment performance
• $187 million of surplus funds directed to offset retiree costs, resulting in no premium increase for retirees
• Significant cost savings for PEIA resulting from a large number of plan participants switching to plans more aligned with their utilization.

Education WV has long advocated for the surplus funds being directed to offset retiree costs. Additionally, the union hosted an online webinar exclusively for members during last spring’s open enrollment period to explain the various plans available and inform them on how to assess which plan met both their health and financial situation, leading many enrollees to switch to a plan that saves both them and PEIA money.

It is important to also point out that PEIA has kept the cost of running the program very low in comparison to other health insurance companies.

• 97.6% of the PEIA budget is spent on paying out plan benefits
• Administrative costs make up the other 2.4% of the budget

In the private health insurance sector, administrative costs are minimally around the 20% range, nationally.

Note: The outlook for non-state employees who are enrolled in PEIA is more dire. Non-state employees (county and municipal employees) are looking at premium increases ranging from 4 to 24%.

Education West Virginia encourages employees to attend a PEIA Public Hearing near them. Education WV leaders will also be speaking at each public hearing.

Public Hearings Scheduled for November 2026

Registration will begin at 5:30 p.m. – Everyone attending the meeting must sign in and indicate if they wish to speak. 

Public Hearing begins at 6 p.m. – The proposal for the 2028 plan year will be presented, and audience comments will be recognized by the board.

• Parking for the Charleston event is in the parking lot on Piedmont Street.
• Parking for the Wheeling event is permitted in the bank parking lot across the street as well as on-street availability.