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County’s self‑funded health plan shows strong network discounts but rising pharmacy costs; broker pushes script‑sourcing and diabetic interventions

5601984 · July 28, 2025
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Summary

The county’s health‑plan broker reported that Aetna network discounts kept overall plan costs favorable but that pharmacy spending rose to represent 40% of early 2025 claims; the broker recommended expanding script‑sourcing and exploring diabetic support programs to curb rising drug costs.

A benefits broker update to commissioners July 28 said Montgomery County’s self‑funded health plan continued to get strong PPO discounts through Aetna, but pharmacy spending has risen sharply this year and now accounts for about 40% of paid claims year‑to‑date.

Representatives from the county’s broker reviewed 2024 plan performance (total plan cost about $2.89 million in 2024) and three months of 2025 data. The county’s aggregate attachment point usage was 68% for the 2024 plan year and about 47% so far in 2025; the broker noted that low…

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