PEIA Health Insurance Details - Updated 21 May 2007

PEIA Update
Plan Year 2008 begins on July 1, 2007. On that date, any changes you made during open enrollment will take effect. Also, medical and prescription drug deductibles and out-of-pocket maximums for all plans (PEIA PPB Plans, HMOs and PPOs) will start anew.

If you're in PEIA PPB Plan A, remember that the family prescription drug deductible will increase from $125 to $150 per year. Also, the copay for non-preferred drugs will increase from $30 to $50 for a month's supply.

Premium discounts for tobacco-free members will reset on July 1. Active employees' affidavits were due by April 30, 2007. If you forgot to turn in a tobacco affidavit, you could be missing out on savings on your health and optional life insurance premiums if you are tobacco-free. You can download a copy of the tobacco affidavit from PEIA's website at www.wvpeia.com. When you've completed it, turn it into your benefit coordinator, Vicki Hammer, and PEIA will process it as quickly as possible.

You will receive a confirmation letter in June that shows what health care plans you have for Plan Year 2008, if any, your tobacco status for Plan Year 2008, and your current life insurance amounts.

We encourage you to watch for that letter and pay close attention to it. If you disagree with the contents, follow the instructions in the letter to make corrections.

PEIA Legislative Update-Dependents May Continue Coverage to Age 25
During the 2007 Legislative session, a bill passed allowing parents to keep unmarried, dependent children on their insurance coverage to age 25. The bill is effective July 1, 2007.

Your unmarried child or stepchild age 19 - 25 will qualify for benefits if he or she meets the definition of a "qualifying child" OR a "qualifying relative." For details of these definitions, go to www.wvpeia.com.

If you have qualifying unmarried children between ages 19 - 25 that you want to enroll for coverage, see your benefit coordinator, Vicki Hammer, for a Change-In-Status form. Complete the form and return it to Vicki. If you get this form to your benefit coordinator before June 30, 2007, coverage will not be effective July 1.

PEIA will not require documentation to add these dependents but will be conducting individual eligibility audits after July 1. If you are audited, you will have to produce either a student verification form for the dependent in question, or your most recent Federal tax return showing that you've claimed the dependent on your taxes. If you cannot prove that the dependent qualifies for coverage, coverage will be terminated retroactively to the date the child would otherwise have been terminated, and PEIA will pursue reimbursement of any medical or prescription drug claims paid on the dependent.

Available Plans - Three plans are available to school employees in Pendleton County:

• PEIA PPB Plan A, which is the plan most all of the employees are currently in;
• PEIA PPB Plan B, which has lower premiums but significantly higher deductibles and out-of-pocket expenses; and
• Carelink HMO.

Premiums - The 2008 premiums will be posted when they become available.

Tobacco-free Discount - All policyholders have to submit affidavits for fiscal year 2008. The discount applies to both health and optional life insurance premiums. There is no discount on basic or dependent life insurance. Please note: The affidavit is on the transfer form. Employees who are not changing plans still have to submit the affidavit for the discounts. A Tobacco Affidavit must be submitted before May 2, 2007 to qualify for 2008 discounts.

Student Verification Form - A student must be attending school full time to be eligible for coverage under the State of West Virginia Public Employee Benefit Plan. Here is the Student Verification Form.