Committee reviews plan to shift PERS enrollees from grandfathered to non‑grandfathered coverage

Summary

Senate Bill 2160 drew data from Sanford Health showing roughly $10.8 million in 2023 member cost‑sharing would have been covered under a non‑grandfathered plan; PERS staff and senators debated offering a voluntary third plan option, possible employee premium amounts and the need for additional study before a larger policy change.

The Senate Human Services Committee discussed Senate Bill 2160 on a proposal to transition the Public Employees Retirement System (PERS) non‑Medicare pool from a grandfathered plan design to non‑grandfathered coverage.

Dylan Wheeler, government affairs with Sanford Health Plan, told the committee Sanford’s data analytics team found about 15,000 employees enrolled in a grandfathered PPO or open‑network plan in 2023. Of those, Sanford estimated 11,851 members paid about $10,846,591 in cost share during 2023 for services that would have been fully covered under a non‑grandfathered plan with the same benefit design. Wheeler said that averages to about $76.27 per employee per month and is roughly 4.6% of the monthly premium in 2023.

Wheeler cautioned the committee that the figure is a utilization average for a single plan year, not an actuarial or premium estimate. He listed several caveats: the analysis used 2023 plan data only, some claims for 2024 remain pending, certain services are not present in the non‑grandfathered benefit design (for example,…

Committee reviews plan to shift PERS enrollees from grandfathered to non‑grandfathered coverage

Summary

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