The VGEA secured passage of the first State Employee Hospitalization Insurance program in 1971 and protecting that program has been at the core of the VGEA mission ever since. The Association works to keep the employee share of premiums low, while ensuring that high-quality health insurance plans are offered to active employees and retirees through the Department of Human Resource Management (DHRM). The VGEA also secured passage of the first retiree Health Insurance Credit (HIC) to help State retirees offset the cost of health insurance after they leave State employment, and has been successful in periodically increasing the amount of the HIC.

State employee and retirement health insurance plans are self-funded through a combination of employer and employee contributions. These funds are placed in the Health Insurance Fund (HIF), a trust fund designed to ensure that sufficient funds are available to pay all employee and retiree claims on both a routine and catastrophic basis. The VGEA is ever vigilant in ensuring that the fund is managed in a sound manner and sufficiently funded to ensure its financial integrity. (Click on the link below to see the Auditor of Public Accounts Report on the HIF.)

VGEA also monitors the third party-administrator (TPA) contracts managed by the DHRM for administration of the health insurance plans to ensure that State employees are receiving the best coverage available at the most efficient cost to taxpayers. TPAs are private vendors hired to develop health care provider networks across the state for the various health insurance plans offered through DHRM and to process all claims and payments. Read more about the plans, health insurance costs and related information by clicking on the links below to the annual plan reports.

VGEA achieved the following victories recently regarding the State employee and retiree health insurance program:

2014

• $83.9 million for biennium to offset impact of premium increases on employees and continue rebuilding HIF reserves;
• Eliminated Tier 1 and 2 co-pays for asthma and hypertension medications;
• Established on-site State employee health clinic near Capitol Square.

2013

• More than $64 million additional funding committed to offset impact of premium increases on employees and begin rebuilding HIF reserves;
• Increased coverage for outpatient surgeries;
• Increased frequency of eye exams from every two years to annually;
• Enhanced diabetes management services including elimination of certain co-pays.

Auditor of Public Accounts Report on the Health Insurance Fund:

http://www.apa.virginia.gov/reports/HealthInsuranceFundSR2011.pdf

DHRM Annual Health Benefits Report for Employees and Non-Medicare Retirees:

http://www.dhrm.virginia.gov/hbenefits/ohbcommunications/reports/annualreport2013.pdf

DHRM Annual Health Benefit Report for Medicare Retirees:

http://www.dhrm.virginia.gov/hbenefits/ohbcommunications/reports/MedicareAnnualReport2011.pdf