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Board approves formulary updates and a slate of benefits contracts, including a UnitedHealthcare premium adjustment
Summary
The board approved changes to the drug formulary, a 3-month retiree pilot contract, renewals for Optum and Colonial Life, approval to pursue a Catalyze Health pilot (estimated $150,000 setup), and a UnitedHealthcare rate adjustment that raises plan costs by $50 per member month (roughly $5 more per affected member).
The State Board of Finance approved a package of benefits and contract actions affecting employee and retiree health coverage, including formulary changes, vendor renewals and a proposed pilot.
On pharmacy coverage, the board reviewed Navitus-proposed formulary updates and consultant recommendations. The presenters highlighted step-therapy additions for some products, removal of the emergency-use Paxlovid formulation because it is no longer produced, and coverage changes such as moving Novolin (a vial) to not covered with grandfathering for one affected member. The board voted to approve the monthly formulary recommendations in a single motion.
The board approved a finalized contract for a three-month "retiree-first" pilot aimed at public-school retirees approaching Medicare eligibility. The contract includes performance guarantees: acknowledgement promises and response-time requirements with $100 credits for missed acknowledgements or responses, and a $1,000 per-calendar-day credit if implementation deliverables are not completed by the go-live date.
The board also approved a one-year renewal for Optum/ConnectYourCare (HSA/FSA administrator) with no rate changes and an amendment to Colonial Life and Accident Insurance (basic $10,000 policy) for another year. The board granted approval to continue exploring a Catalyze Health program that would pay the premium difference to move eligible employees onto a spouse's employer plan; staff estimated implementation costs around $150,000 and anticipated uptake under 3% among new hires.
Finally, presenters described changes tied to the Inflation Reduction Act affecting Medicare Advantage and Part D. UnitedHealthcare proposed a plan-level increase of $50 per member per month to smooth cost exposure over coming years; presenters said that translates to roughly a $5-per-member monthly premium increase for affected individuals, with recommended new premium levels of $22.53 for state employees and $14.53 for public-school retirees. The board voted to approve the UnitedHealthcare services contract as presented.
Board members requested feasibility check-ins on pilot programs and regular reporting on implementation milestones. No public comment was recorded on these items.
