Duplin County to pursue United American supplement after retirees warn Humana/Express Scripts exits will cut local access

Duplin County commissioners voted to give county staff authority to move retirees from the county’s Humana plan to a United American Medicare supplement and to continue negotiating pharmacy (Part D) coverage after a string of public comments warned local providers and independent pharmacies could be cut out of plan networks.

At the meeting, multiple retirees described notices they received saying UNC Health would not accept Humana effective Jan. 1, 2026. “If we were seeing a provider with UNC Health, it means that we have to find another one,” said Judy Brown, a Duplin County retiree. She told the board the disruption could be “devastating” for people on active cancer treatment and urged the county to ensure retirees keep access to local providers and pharmacies.

Director Perry (county staff) presented staff’s recommendation after receiving retiree complaints and working with the county’s broker. Perry said UNC Health’s decision to stop accepting Humana would affect roughly 20% of post‑65 retirees and recommended moving retirees to a United American supplement to preserve access to existing providers. Perry told the board switching to the United American supplement would make Medicare Part A and B primary with United American as secondary and would “open access” to the providers retirees currently see.

Local pharmacists and pharmacy operations staff told commissioners the county’s current drug plan structure — and pharmacy benefit manager contracts — make it difficult for independent pharmacies to remain in network. Bobby Rawls, pharmacy operations director for Reload Drugs, said PBMs and negotiated contract networks often leave independent pharmacies with reimbursement rates that are below cost. “You have to fight these PBMs,” Rawls said, arguing the county’s broker should push for plans that allow retirees to fill prescriptions at independent pharmacies in Duplin County.

On costs, staff provided preliminary premium comparisons during the meeting. As presented, the county’s share of the current Humana supplement and the proposed United American supplement differed in monthly totals; county staff presented the Humana scenario as roughly $16,005.95 per month on the county’s portion at the current enrollment figure and estimated the county’s monthly share under the United American supplement at about $18,241.95 per month. County staff said those figures were preliminary and tied to enrollment assumptions and broker proposals.

Commissioners debated whether switching would also fix the separate Part D (prescription drug) network problem. Director Perry said the United American supplement would protect provider access but that the Express Scripts/Part D issue required additional negotiation with the county’s broker and with AmWINS; commissioners amended a motion to remove a single‑vendor tie and give staff flexibility to negotiate Part D coverage. The amended motion delegates authority to the county manager and deputy manager to contract with United American and to negotiate Part D pharmacy coverage; commissioners voted in favor by voice vote.

Perry said staff is assembling contact information for post‑65 retirees and scheduled an informational session for Nov. 17 at 1:30 p.m. at the Ed Emery Auditorium to allow retirees to meet the broker and ask enrollment questions.

The board’s adoption of the delegated authority does not itself change retirees’ coverage until staff executes a contract and communicates enrollment steps; commissioners instructed staff to continue trying to identify Part D solutions that would allow retirees to use local independent pharmacies.