[{"_1":2,"_99":-5,"_100":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,76,88],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},"mediaId",6183000,"mediaKeyId","5100805-7a85987df9d5cbb9bc112bf738fd699f","parentId",5100805,"title","PEHP begins new core system; pharmacists warn PBM contracting and low dispensing fees threaten local pharmacies","audioSeconds",475,"startMs",5706000,"endMs",6181000,"viewUrl","/Search/View?dp=1&key=5100805-7a85987df9d5cbb9bc112bf738fd699f&start=5706&end=6181","thumbnailUrl","https://assets.pipeline.soar.com/5100805-7a85987df9d5cbb9bc112bf738fd699f/thumbnail_5706000.jpg","articleUrl","/articles/6183000/Utah/PEHP-begins-new-core-system-pharmacists-warn-PBM-contracting-and-low-dispensing-fees-threaten-local-pharmacies","mediaUrl","https://secure.pipeline.soar.com/6183000-3af9140a67bf8c7614e9d4b299b675b9/orig.mp4?Expires=1770541840&Signature=cbRYc5-zmpeJ8U5EQbzMNY3~x5bjJdv8~lrDwBIc-w5r47pja61zvbL~oJaVfmFi3dPQmNpyhxezioqPlfZ1tMV7sjr6YkLlu5tB-mDTc7YwwG4wpiRvvQfgNvJsKjvwzjONFj~hbffJHyYIco4bse-UXWwH~uWqCNTpoDzRVWYH9~I~yTuMKBxLpkEEBp98cvVfEgQ7tamw6Vvl6c9zVAdDbt2~7V2qjI8XJXLnAYjmAkK41rcG6wEynQO55NBqyM5h4chgYdYnRblK29C2atTd9ukHbBFhq57pU8hoTFMf1VTerymjdacvJ-XpLJDK4AB~zJHj4xKnN9F04CBuaQ__&Key-Pair-Id=KUT5TJCACFTXG","author","Utah Legislature","date","2025-06-19T00:00:00Z","article","PEHP representatives told the Retirement and Independent Entities Committee that the health-plan administrator has begun transitioning members to a new core claims system and distributing new member cards that carry a July effective member number, while independent pharmacists and the Utah Pharmacy Association pressed lawmakers about pharmacy reimbursement and pharmacy-benefit-manager (PBM) contracting practices.

Chet Loftus, speaking for PEHP, described a multi-year effort to replace an aging internal IT platform with a configurable vendor-backed system intended to increase automation and reduce manual claims adjudication. PEHP has run pilot cohorts (including a January 2023 group) and completed phased work needed to issue new member cards. Loftus asked members and providers to use the existing PEHP card through June 30 and to present the new card (the number begins with an \"M\" and the card is marked \"JUL\") to providers on July 1 to ensure claims route to the correct system. \"The old system is completely good, valid, 100%, and we want you to use that until June 30,\" Loftus said. He emphasized the operational risk of overlapping claims and said PEHP built website tools and provider communications to reduce mismatches during the switchover.

Loftus also previewed consumer tools to show price differences by site of care and drug options; PEHP plans to expand cost-transparency and co-pay tools that flag lower-cost outpatient and imaging alternatives and display drug-price comparisons for traditional-plan and HSA members.

After the PEHP briefing, the Utah Pharmacy Association and independent pharmacists told the committee that PBM contracting, spread pricing and low dispensing-fee reimbursements threaten small, community pharmacies. Adam Jones, executive director of the Utah Pharmacy Association, summarized federal and state trends and cited a state dispensing-fee study used in Medicaid that placed the average pharmacy cost to dispense at about $11.53 per prescription. \"Currently that dispensing rate is a little over $11 per prescription,\" Jones said, and he warned many independent pharmacies receive reimbursements well below that level.

Independent owner Sheldon Birch described concrete examples from his pharmacies and said that, after accounting for product acquisition cost, his stores averaged roughly $4.63 gross profit per PEHP claim on 17,000 PEHP claims in the year-to-date data he reviewed—well below the state-estimated dispensing cost. Birch and the association also described so-called \"spread pricing\" in which a PBM reimburses a pharmacy at a rate below the PBM's reimbursed or reported price to the payer, producing a retained margin for the PBM.

PEHP and committee members discussed contracting approaches. Loftus said PEHP uses a PBM to obtain broad pharmacy networks, formulary negotiations, claims adjudication and rebate management; he said a 2019 legislative audit found PEHP’s non-transparent contracting produced lower net costs to the state and that PEHP receives its full rebates. Loftus also told the committee PEHP is open to exploring different contracting approaches and that PEHP negotiates on total value (network breadth, rebates, adjudication performance) when selecting PBM arrangements.

The committee authorized the chairs to open bill files if needed for legislative solutions, and members asked PEHP and stakeholders to report back with more detailed cost and contracting options if the group wants to pursue statutory change. Representative Thurston additionally asked that the chairs be informed at each meeting of any bill files PEHP opens going forward.

The PEHP transition will keep the old card active through June 30; members should present new \"M\"-number cards to providers beginning July 1 to route claims correctly. PEHP reported current administrative costs embedded in premiums (about 3.7 percent administrative expense noted in the presentation) and said it funded the system transition without a separate appropriation using premium revenue and plan growth.","mediaType","Video","parentTitle","Retirement and Independent Entities Interim Committee - June 19, 2025","oneSentenceSummary","The Public Employees Health Program (PEHP) told the committee it has started a phased rollout of a new core claims system and new member cards; independent pharmacy representatives testified that pharmacy benefit manager (PBM) contracting and low dispensing-fee reimbursement squeeze community pharmacies and reduce access.","taxTitle","2025 Utah Legislature, Utah Legislature, Utah Legislative Branch, Utah","taxId",78171,"location","Utah","headline","","shortSummary",{"_33":77,"_35":36,"_37":38,"_39":78,"_41":79,"_43":80,"_45":81,"_47":82,"_49":83,"_51":84,"_53":85,"_55":56,"_57":58,"_59":86,"_61":62,"_63":64,"_65":87,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6183005,"Retirement committee adopts 2025 study list and adds review of moving new hires to defined-contribution plans",252,1811000,2063000,"/Search/View?dp=1&key=5100805-7a85987df9d5cbb9bc112bf738fd699f&start=1811&end=2063","https://assets.pipeline.soar.com/5100805-7a85987df9d5cbb9bc112bf738fd699f/thumbnail_1811000.jpg","/articles/6183005/Utah/Retirement-committee-adopts-2025-study-list-and-adds-review-of-moving-new-hires-to-defined-contribution-plans","https://secure.pipeline.soar.com/6183005-89b2402216005a836ff1ec9ecfa584b9/orig.mp4?Expires=1770541840&Signature=cek12xp8iL4DzJIwEX8poLQZ3mLrTjvdGj9PFCnJiu1igTdWBz4OdhF1TI6ipsBJgQsrU95kjjTpNd8t1-FU9kSEmBMbxqbx0e8Tj04imhnibAiVohPAb6EkfHn8Hpez3Te0NFIs8fyCfxTvnoI3ULKyke3csY34yiA545FZB6wHtS8H51bEdFPMDcARPsfjCZm8FTUk8mFUvRO5pcKLS8AWAemPfOHo7AJ0PDC4r26SyEdJFaCYmAHsVqDSNVGAaZ73zeHWBEFqvCntQY2outuhZpt3tXIGfbiiY8XktMA0RLURwjMK0w~4ikj1V6RZehu9PhRfWKkEQYu5aGoEiw__&Key-Pair-Id=KUT5TJCACFTXG","The Retirement and Independent Entities Committee voted unanimously to adopt its 2025 list of study items and to add two items proposed by members: a review of whether to phase new employees into a defined-contribution-only retirement program and a study of processing time for retirement applications.

The study list as presented by Office of Legislative Research and General Counsel staff included multiple URS-related items—administrative and technical modifications to Title 49, an overview of URS and its annual reports, the AURUS recordkeeping upgrade, the line-of-duty death benefit discussion, and preliminary contribution-rate review. Representative Kristofferson proposed adding a review of phasing out defined benefits for new employees. \"Maybe we ought to phase out of the defined benefit program and just have new employees just go on the defined contribution program,\" Kristofferson said.

Representative Thurston moved to add that study item; the committee voted in favor and later also approved adding processing time for retirement applications after noting potential follow-up from the Rules Review and Government Oversight Committee. \"I would move that we add, processing time for post retirement receipt of benefits to our study list,\" Thurston said; the motion passed by voice vote.

Committee members clarified what a defined-contribution-only transition would mean in practice and asked URS staff to present comparative analyses. URS and other speakers explained the trade-offs: defined-contribution plans are administratively simpler and shift long-term investment risk to members, while defined-benefit plans spread longevity and investment risk across a large pool of members and employers. URS staff emphasized the policy choice underlying benefit design: “What is the problem you’re trying to solve?” they said, noting Utah’s previous tier 2 reforms and the long time horizon for pension impacts.

Formal committee action: the committee adopted the study-item list (including previously proposed items such as the line-of-duty benefit review) and approved the two additions by unanimous voice vote. The committee also asked staff to report back on processing-time work already considered by other committees and to bring any necessary policy proposals back to the committee for consideration.

Next steps noted in the meeting included URS presentations on funding status and actuarial assumptions later in the year, and staff follow-up on both the defined-contribution-versus-defined-benefit analysis and the processing-time review for retirement applications.","The committee unanimously approved a set of study items for 2025, adding a proposal to analyze phasing new hires into a defined-contribution-only model and a study on processing times for retirement applications.",{"_33":89,"_35":36,"_37":38,"_39":90,"_41":91,"_43":92,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":72,"_73":74,"_75":74},6183009,"Committee hears gaps in line-of-duty death benefits for Utah public safety employees",0,2644000,"/Search/View?dp=1&key=5100805-7a85987df9d5cbb9bc112bf738fd699f&start=2644&end=2644","https://assets.pipeline.soar.com/5100805-7a85987df9d5cbb9bc112bf738fd699f/thumbnail_2644000.jpg","/articles/6183009/Utah/Committee-hears-gaps-in-line-of-duty-death-benefits-for-Utah-public-safety-employees","https://secure.pipeline.soar.com/6183009-b1acff251be5d9d87f68ae1d9af626f1/orig.mp4?Expires=1770541840&Signature=b0ftSAtrZHqx6keiHGXM0am3MNm9PxEehHK8j3V~pYRWedXr8EFKSSWHawxtB9C3G-deNnMoxGgR83Rffyjmi9Rnj1OynaojNPSOorP2hQ0xcTYK7iemMCDw89SqX6C3EwpygGc8jDvLC0xMXW4~M5e0kcK1W~RaBLm9acI-43ndNf2loY6xy9UZAtKeBE1Cq47wXc4oFSQqojLn3x-jPsUao9V~EydScKn7huve5cRU~7Ir2K~h2PBY9ImGqhE6LDzvAT5INF2NYD4Fhw~AfL-dcKX2X9m7PemldG6GR6BtLqp~0zcCo2DOaHE98Xda0U4rYS3cF7ORbzySxMsIYg__&Key-Pair-Id=KUT5TJCACFTXG","At the Retirement and Independent Entities Committee’s first meeting of 2025, lawmakers and Utah Retirement Systems (URS) staff reviewed statutory and programmatic differences in benefits that apply when a public safety employee dies in the line of duty and identified gaps affecting newer employees under tier 2 retirement options.

The discussion mattered because tier 2 members who choose the defined-contribution (401(k)-style) option may have only a modest account balance early in their careers, leaving survivors with much smaller lump-sum payments than beneficiaries of the hybrid/defined-benefit option. “We started to learn about the…holes here,” said Senator Owens, referring to cases that highlighted differences between tier 1 and tier 2 benefits.

URS general counsel D. Larson and URS analyst Corey Cox summarized how state law defines a line-of-duty death and how benefits differ by plan and division. Cox said the statute (Title 49) treats a line-of-duty death as one “that results from external force, violence, or disease occasioned by an act of active duty as a public safety service employee,” and that URS averages final salary differently depending on plan: tier 1 uses a three-year final average salary formula while tier 2 uses five years.

URS staff walked the committee through benefit mechanics. In tier 1 Division A (Social Security–participating employers), a qualifying surviving spouse receives a six-month final average salary lump sum and a monthly benefit equal to 30 percent of the final average salary; if the member had 20 or more years of service the spouse receives a benefit equal to 65 percent of the retirement benefit. In tier 2 hybrid plans the survivor benefit generally includes a lump sum equal to six months of final average salary plus allowances described by Cox; in the defined-contribution option beneficiaries generally receive 75 percent of the highest annual salary plus the vested 401(k) balance, which early-career accounts may not contain in significant amounts.

Cox provided program counts and frequencies used by URS staff: roughly one line-of-duty death per year in the public safety system and about one every two years in the firefighter system. He also listed other potential sources of support for beneficiaries, including the federal Public Safety Officers’ Benefits program (federal lump-sum awards currently in the federal program were described as roughly $450,000), Social Security survivor benefits, workers’ compensation, employer-provided life insurance (the state provides a $50,000 life-insurance benefit to state employees in statute), and private or nonprofit scholarships and foundations.

Lawmakers focused on two categories of response: education and benefit design. Some members described the issue as partly one of awareness—new hires must make a one-time choice in their first year about hybrid versus defined-contribution—and URS staff said enhanced education and enrollment counseling could reduce inadvertent gaps. Other lawmakers asked whether the committee should consider benefit changes or an insurance-style add-on for employers to purchase low-cost line-of-duty coverage. ‘‘If it’s early in the career…there’s not a ton of money potentially in that 401(k),’’ Cox said, urging consideration of education and possible programmatic options.

Committee members agreed to keep the topic on the committee’s study list so staff and stakeholders can return with more analysis, cost estimates and options at a future meeting. The committee later adopted a broader study list that includes the line-of-duty death benefit discussion for further study.

Background details and technical clarifications from URS at the meeting included: the tier 1 final-average salary calculation uses the average of the three highest years; tier 2 uses the highest five years; the hybrid tier 2 default option is chosen by about 85 percent of new employees; and URS staff said employer-purchased line-of-duty insurance (examples include agencies that purchase a line-of-duty policy for fire or forestry personnel) can be inexpensive—for example, URS staff estimated roughly $1.33 per month for every $50,000 of coverage in one illustrative pricing example.

The committee did not adopt any immediate statutory change in the meeting but committed to a follow-up staff review and possible analyses of insurance or benefit-design options.","At the committee's first 2025 meeting, lawmakers and Utah Retirement Systems staff reviewed how line-of-duty death benefits work for public safety employees and flagged gaps for early-career employees under the tier 2 retirement options.","actionData","errors"]

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PEHP begins new core system; pharmacists warn PBM contracting and low dispensing fees threaten local pharmacies

Retirement committee adopts 2025 study list and adds review of moving new hires to defined-contribution plans

Committee hears gaps in line-of-duty death benefits for Utah public safety employees