PEIA Finance Board Adopts PY 2020 Plan

The PEIA Finance Board met on December 20, 2018, and adopted the Governor’s recommendations to the PEIA Task Force for Plan Year 2020, which begins on July 1, 2019.  The plan includes the following changes:

For active employees, non-Medicare retirees and non-state agencies in the PEIA PPB Plans:
• Plan A back to 80/20 coinsurance for approved services in WV external bordering counties only
• Plan B back to 70/30 coinsurance for approved services in WV external bordering counties only
• Remove facility fee limits
• Remove $25 copay for out-of-state services
• Add an appeal process for people requiring a third-tier non-preferred drug to allow for reduced cost
• Discontinue the Healthy Tomorrows Program
          *There will no longer be an annual requirement for blood work in FY 2020, so nothing to do between now and May 15 
          * We are continuing to evaluate the program for future years and exploring new wellness options for the future
          * New programs
           - Pilot project – Naturally Slim (weight loss and health)
           - Diabetes Prevention Project – evaluating services
          -  Other programs are being explored
For Medicare retirees:
• Received 2-year rate guarantee from Humana
• No benefit changes for Plan Years 2019 or 2020
• Probably will see formulary changes for 2020, since those changes happen regularly

These changes will be detailed in the Shopper’s Guide prior to Open Enrollment.