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District insurer reports improved 2024 year but warns GLP‑1 drugs threaten plan affordability
Summary
The district’s benefits consultant reported lower overall medical claims in 2024 but large growth in GLP‑1 prescription spending; staff said federal action or negotiations will be needed to control costs for those drugs.
The Saint Mary Parish School Board received a group health insurance update Jan. 9 showing improved overall claims experience in 2024 compared with 2023, but with sharply rising prescription costs tied to GLP‑1 drugs.
Presenter Mister Perez said the district paid $12.8 million in premiums for the 2024 plan year, with $11.8 million in total claims paid. A stop-loss adjustment related to claims above the attachment point ($175,000) was $790,000. Medical claims decreased 16.5% from 2023, while prescription drug claims rose 25%.
Of 85 large claims (over $25,000) in 2024, 34 were pharmacy-related. Perez highlighted three GLP‑1 drugs (discussed as Wegovy, Ozempic and another agent) that accounted for $1,377,294 in 2024 — a 65% increase over 2023 — and represented roughly 25% of total drug spend. He described GLP‑1 medicines as clinically beneficial for diabetes and weight loss but said the U.S. price is far higher than in other countries and that public plans nationwide are feeling unsustainable pressure. Perez estimated a 2.4% premium rate increase for 2025 driven in part by the drug trend.
Board members asked whether the district could limit access or narrow coverage for the drugs; Perez said the district’s plan is fully insured and does not have unilateral authority to impose such limits. He suggested advocacy with congressional representatives and anticipated federal-level policy responses — price negotiation authority or other interventions — as likely remedies.
Ending: District staff will continue to monitor claims and will advise the board on rate or plan changes if needed; no policy change or coverage restriction was adopted at the meeting.
