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Insurance committee recommends Stelara biosimilar coverage, 30‑day specialty fill limit, and independent audit
Summary
The insurance committee recommended adding a Stelara biosimilar program to group insurance effective Jan. 1, 2026, adopting a 30‑day limit for specialty drug fills, and authorized an independent audit contract with BMI starting January 2026; the full board approved these committee recommendations.
Insurance Committee Chair Robert Bertrand reported the committee’s December 4 meeting and its unanimous recommendations to the full board. The committee proposed adding a Stelara biosimilar program to the district’s group insurance plan effective Jan. 1, 2026, and a 30‑day limit for specialty drug prescription fills for specialty drugs, also effective Jan. 1, 2026.
CFO Nisha Bamberg informed the board that the district has signed a contract with BMI to begin an independent audit in January 2026; that audit was presented as informational in the committee report. Bertrand said the committee’s items passed unanimously out of committee and were recommended to the full board, and the board subsequently approved them by electronic vote.
The measures affect the district’s employee benefits and pharmacy administration; the committee report did not provide detailed cost estimates in the public transcript.
