The bill proposes a comprehensive overhaul of the West Virginia Public Employees Insurance Agency (PEIA) by dissolving it and establishing a new entity, the Public Employees Mutual Insurance Company, which is set to be operational by July 1, 2025. This transition includes the transfer of PEIA's functions, rights, responsibilities, employees, and assets to the Insurance Commissioner and the Public Employees Insurance Council. The bill introduces a new article, the West Virginia Public Employees Insurance Privatization Act, which outlines the governance structure, including the election of a board of directors for the mutual insurance company, and establishes provisions for private carriers to insure public employees. It also emphasizes the importance of retraining benefits for employees laid off during the transition and mandates comprehensive health coverage options, including mental health services and treatments for autism spectrum disorder.

Additionally, the bill modifies existing laws to clarify the roles and responsibilities of the agency's director and finance board, ensuring a diverse representation of interests. It establishes a cost-sharing structure for premiums, with an 80% contribution from employers and 20% from employees, and allows for the development of insurance plans that can be sold on the open market. The bill mandates coverage for specific medical conditions, including colorectal cancer screenings and breast reconstruction following mastectomies, while also allowing for cost containment measures related to autism spectrum disorder. Overall, the legislation aims to enhance the financial sustainability and effectiveness of health insurance for public employees in West Virginia while ensuring equitable access to necessary medical services.

Statutes affected:
Introduced Version: 5-16-1, 5-16-2, 5-16-3, 5-16-4, 5-16-5, 5-16-7, 5-16-7a, 5-16-7c, 5-16-7d, 5-16-8, 5-16-9, 5-16-10, 5-16-11, 5-16-12, 5-16-12a, 5-16-13, 5-16-15, 5-16-16, 5-16-17, 5-16-18, 5-16-24, 5-16A-1, 5-16A-2, 5-16A-3, 5-16A-4, 5-16A-5, 5-16A-6, 5-16A-7, 5-16A-8, 5-16A-9, 5-16A-10, 5-16A-11, 5-16A-12, 5-16A-13, 5-16A-14, 5-16A-15, 5-16A-16, 5-16A-17, 5-16A-18, 5-16A-19, 5-16A-20, 5-16-7e