PEIA says open enrollment was active following changes, assesses spousal surcharge

Managers of the Public Employees Insurance Agency are encouraged by open enrollment, which has come after big changes to the program.

And they are monitoring the results of opt-ins for spouses following the establishment of a surcharge.

“We’ve had one of the largest open enrollments you can imagine,” acting PEIA director Jason Haught told finance board members during a Thursday afternoon meeting.

Online, the insurance plan had more than 20,000 finalized enrollment transactions, he said. Among people who filled out enrollment forms on paper, Haught estimated about 30,000.

“This is a critical open enrollment. We’re really anxious to see the final numbers,” Haught said.

Open enrollment means people who are insured through PEIA can change their health plan or coverage without some other qualifying event. The most recent period was from April 2 to May 31.

The PEIA Finance Board is getting a feel for the effects of several significant changes for how the plan operates, which were part of a broad-ranging bill passed by the Legislature during the most recent regular session:

• Imposition of the spouse surcharge for active employee policyholders from state agencies, colleges, universities, and county boards of education whose spouses are offered employer-sponsored insurance coverage but who choose to get coverage through a plan offered by PEIA. This change does not affect non-state agencies, retirees, spouses who are employed by PEIA-participating agencies, or spouses whose coverage is through Medicare, Medicaid, or TRICARE.
• Increasing health premiums to get the plan back to an 80/20 employer/employee premium split for state agencies, colleges, universities, and county boards of education by July 1, 2023.
• Increasing reimbursement to providers to a minimum of 110% of Medicare’s reimbursement.

Haught reported to board members some preliminary information about trends on the spousal surcharge.

“That was the big question,” Haught said. “Were our assumptions accurate to what actually happened?”

PEIA had asked people who might be affected by the spousal surcharge to respond to an affidavit and got a 73 percent response rate, Haught said.

PEIA had assumed 45 percent of spouses on the plans did not have employer coverage available to them. That would have been a few more than 11,000 policies.

“We were pretty accurate,” Haught said.