Health plan costs to rise for some Virginia state workers

Some Virginia state employees will pay more for health insurance beginning July 1, following the state's latest review and projection of claims.

Overall, the state Department of Human Resource Management proposed a 6.3% increase in total premiums for the next fiscal year.

But full-time employee contributions — the sums taken out of paychecks — will rise by less than that. For some plans, there will be no increase at all.

The increase in total premiums is lower than the national average of 7%, the department said in a report to the secretaries of finance and administration and senior staff in the governor's office.

The 6.3% increase is what budget writers expected, according to a House Appropriations Committee analysis of the budget proposed by Gov. Glenn Youngkin in December.

The General Assembly's rewrite of that proposal did not change the sums set aside for employee health coverage.

The assembly's budget and amendments Youngkin recommended to it are now on ice. Both sides say they want to start afresh with a new budget proposal that lawmakers will consider at a special session in mid-May.

For the state's basic COVA Care health plan, employee contributions would rise from between 5.5% and 6.2%, depending on whether an employee covers just him- or herself, or one other person or two or more additional people.

Percentage increases are smaller on the higher employee contributions for COVA Care plans that add out-of-network coverage, expanded dental coverage, and vision and hearing coverage.

ER co-pay will rise to $300

The plan administrator, Anthem, is increasing the emergency room co-pay to $300 from $150, while adding cancer care navigator, hearing aid coverage for children under 19, texting for mental health care and virtual physical therapy services.

Employee contributions do not change for the higher deductible basic COVA HealthAware plan with its attached "health reimbursement arrangement" account to cover out-of-pocket expenses.

HealthAware plans that add expanded dental coverage will have increases of $1 to $2 a month, but employee contributions for the expanded dental and vision coverage option would not.

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Employees do not have to contribute anything if they opt for the state's high-deductible plan, while their contributions for high-deductible plans with expanded dental coverage would remain unchanged.

Aetna, which administers the HealthAware plan, and Anthem, administrator of the high-deductible plan, are also adding the children's hearing aid coverage, virtual physical therapy and text-based mental health service as benefits.

The state picks up the bulk of the cost of health plans for state employees who work more than 30 hours a week.

Those who work fewer than 30 hours must pay for the full premium.

These total premiums range from $665 a month for less than 30-hour-a-week employees who cover only themselves on the high-deductible plan, to $2,578 a month for employees covering two or more others with COVA Care, including additional out-of-network, expanded dental, and vision and hearing coverage.

Affordable Care Act coverage for a family of three in Richmond ranges from an average of $1,302 to $1,491, depending on the company, according to rate filings with the State Corporation Commission's Bureau of Insurance. Individuals' out-of-pocket spending for many of these are higher than for state employee coverage.