PEIA Finance Board Members Approve Benefits Plan

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CHARLESTON, W.Va. (AP) – Public Employees Insurance Agency Finance Board members have approved a benefits plan with no premium increases or cuts in benefits.

However, the Charleston Gazette-Mail reports they didn’t roll back a proposal to eliminate penalties for insurees who seek care from out-of-state providers to apply only to counties bordering West Virginia.

As adopted Thursday, the 2019-20 plan will waive penalties originally intended to encourage insurees to seek in-state care, including a $25 per visit copay. That applies only to counties bordering West Virginia. The higher rates will remain in place for out-of-state providers beyond border counties.

The plan also adds an appeals process for insurees 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.