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Council amends prescription deductible, approves Rx-management option for city health plan
Summary
Gulfport council amended its group health plan to add a per-member prescription deductible set at $40 and approved an Rx-management option with a $3-per-employee monthly cost intended to lower high-cost drug spending; council members said the change aims to avoid a payroll-premium increase.
The Gulfport governing body voted to add a calendar-year prescription deductible and to adopt an optional prescription-management service intended to reduce spend on very high-cost drugs.
City staff proposed a $50 per-member deductible for prescription medications but council members amended the proposal to set the deductible at $40 per member per calendar year. The council debated whether that deductible would be per employee or per covered dependent; staff clarified it applies per covered member and that employees may use flexible spending accounts to meet the deductible. Councilmember Buckner moved to change the deductible to $40 and the amendment was accepted; the resolution as amended was approved.
Separately, the council approved an optional prescription-management program (described in the record as a program managed by a vendor to source high-cost medicines through direct-fulfillment channels). The program carries a city-plan expense of $3 per employee per month (the fee is paid by the plan, not deducted from employee pay), and staff told the council that actuarial estimates from the plan administrator suggest substantial savings are possible; an example figure cited in the discussion was roughly $295,000 in savings if 40% of eligible users participate. Staff said the vendor will refund plan-fee amounts if program savings do not offset the per-employee charge.
City counsel asked staff to confirm whether employees who use the vendor option would still have any copay; staff agreed to confirm the precise employee cost impact and to record the understanding in the resolution. The council's stated intent in both actions was to avoid a general rate increase in employee payroll deductions by making limited plan design changes that shift some cost to claimants of prescription drugs rather than broad premium increases.
Councilors said the $40 deductible was intended to protect employees who do not use prescription drugs from premium increases and to recover some cost from claimants of higher-cost pharmacy claims. The council approved the deductible amendment and the Rx-management option as amended and recorded in the meeting minutes.
