West Virginia Raised Public Workers' Health Premiums 14%. One Drug Category Was $53 Million of the Reason.
Summary
PEIA, the plan covering West Virginia's state employees, teachers, and retirees, approved $113 million in premium and cost-sharing increases for fiscal 2026 — citing GLP-1 drugs, which cost the agency $53 million the year before, as a lead driver. Nationally, only 43% of large employers cover the same drugs for weight loss, per KFF's 2025 survey, up from 28% a year earlier — most workers absorbing rising costs don't get the benefit at all.
The bill, split three ways
PEIA doesn't charge one rate. State employees, local-government employees, and retirees each pay into separate premium schedules, and the Finance Board raised all three — unevenly.
View data as table
| Local government employees | +16% | FY2026 |
|---|---|---|
| State employees | +14% | FY2026, avg. +$31.50/mo |
| Retirees | +12% | FY2026 |
State employees' premiums rose 14%, an average of $31.50 a month, per the board's own presentation. Local government employees — county staff enrolled through PEIA's local fund — took the largest percentage hit, 16%. Retirees rose 12%. Out-of-pocket maximums for state and county employees, and for non-Medicare retirees, rose 40% on top of the premium increases.
The single largest per-line change wasn't a premium at all. Senate Bill 268, passed in 2022, requires PEIA's spousal surcharge — the extra charge for covering a spouse who has other employer coverage available — to reflect the actuarial value of that coverage. The board's recalculation more than doubled it.
View data as table
| FY2025 monthly surcharge | $147 | |
|---|---|---|
| FY2026 monthly surcharge | $350 | +138% |
A cost most workers don't get covered
PEIA's $53 million GLP-1 figure isn't a West Virginia quirk. The drugs are reshaping prescription-drug budgets everywhere employers pay the bill — but coverage itself is rationed by employer size, which means the cost pressure is far more evenly spread than the benefit is.
View data as table
| 200–999 workers | 16% | 2025 |
|---|---|---|
| 1,000–4,999 workers | 30% | 2025 |
| 5,000+ workers | 43% | 2025, up from 28% in 2024 |
Among the largest employers — 5,000 or more workers, the tier PEIA's roughly 1,500-office footprint would sit in if it were a private company — coverage jumped from 28% in 2024 to 43% in 2025. PEIA suspended its own obesity-coverage pilot in 2024, even as it absorbed the cost pressure GLP-1 prescriptions put on diabetes and other covered uses. Two in three of the largest employers nationally told the drugs had a "significant" impact on their prescription-drug spending, whether or not they cover them for weight loss at all.
The takeaway
- One drug class, cited as a lead cause of a nine-figure increase. PEIA's Finance Board raised $113 million in premiums and cost-sharing for FY2026 and named GLP-1 inflation — $53 million in net cost the year before — as a primary driver, alongside a legislatively mandated spousal-surcharge recalculation.
- The increase lands unevenly. Local government employees saw the steepest premium increase (16%), state employees averaged $31.50 more a month (14%), and the spousal surcharge more than doubled, to $350 a month.
- The cost is closer to universal than the benefit is. Nationally, only 43% of the largest employers cover GLP-1 drugs for weight loss even now — but a majority of them still report the drug class hit their drug budget hard, covered or not.
PEIA figures describe one state's plan and one board action; they are not a national total. The GLP-1 net-cost figure is as stated by PEIA's director in December 2024 and reflects the prior year's spending, not FY2026. 's employer figures are a national survey and are not specific to public-sector plans.
Sources
- Lori Kersey, West Virginia Watch, "PEIA finance board approves rate increases for 2026" (Dec. 5, 2024) — the $113 million total increase package, the 14%/16%/12% premium increases by group, the 40% out-of-pocket-maximum increase, the spousal surcharge change from $147 to $350, and PEIA director Brian Cunningham's statement that GLP-1 drugs cost the agency $53 million in net costs the prior year. westvirginiawatch.com
- West Virginia PEIA/RHBT Finance Board — meeting presentation, Dec. 5, 2024: the average $31.50/month state-employee premium increase and underlying plan-change detail, as approved by the board. bloximages/wvgazettemail hosting
- / Peterson- Health System Tracker, "Perspectives from Employers on the Costs and Issues Associated with Covering GLP-1 Agonists for Weight Loss" (Oct. 22, 2025) — employer GLP-1 coverage rates by firm size for 2025, the 28%-to-43% year-over-year increase among the largest employers, and the share reporting a "significant" impact on prescription-drug spending. healthsystemtracker.org
- , 2025 Employer Health Benefits Survey — the underlying annual survey 's GLP-1 brief draws its firm-size breakdowns from. kff.org
Comments
Always open. Logged-in readers can annotate paragraphs in place.
The Public Employees Insurance Agency covers West Virginia's state workers, county school employees, local government staff, and retirees — roughly 1,500 offices and agencies' worth of people, all on one plan. On December 5, 2024, its Finance Board approved $113 million in premium and cost-sharing increases for the fiscal year that began the following July. PEIA's director, Brian Cunningham, pointed to one line item as a lead cause: GLP-1 drugs — the class that includes Wegovy, Ozempic, and Zepbound — which he said had cost the agency $53 million in net costs the year before.