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Morehead City narrows GLP‑1 coverage, approves 8% health plan renewal
Summary
The council approved an 8% renewal for the city’s 2026–27 health plan that carves out GLP‑1 drugs for weight loss from employer payment; employees may still obtain prescriptions but would pay cash. The measure passed 4–1, with Mayor Pro Tim Ballou dissenting.
Morehead City Council voted on Feb. 10 to adopt an 8% renewal for the city’s 2026–2027 health insurance plan and to exclude GLP‑1 drugs prescribed solely for weight loss from plan payment, a move officials described as a cost‑saving carve‑out.
Benefits staff outlined two options for the self‑insured medical plan: an 8% premium increase that would exclude GLP‑1 weight‑loss coverage (option A) and a 12.5% increase that would retain the current coverage. "The first option showcases an 8 percent renewal over current medical rates," said Kristen, a city benefits staffer, who explained that employees prescribed GLP‑1s for diagnoses other than weight‑loss (for example, diabetes) would continue to have coverage but that weight‑loss–only prescriptions would not be paid by the plan.
Council members focused discussion on costs and clinical use. Staff said the 8% option represents roughly $159,181 more in employer funding this year, while the 12.5% option would raise employer costs by about $248,722; the funding difference between the two options was reported at about $89,541. Officials noted that roughly seven plan members are using GLP‑1 prescriptions now, with about $100,000 in claim spend attributed to those prescriptions. Kristen said commercial pricing for these drugs can be on the order of $1,000–$1,250 per month per dose while a direct‑to‑consumer cash price often cited in the discussion was about $350 per dose.
Supporters of the 8% option said it preserves access for medically indicated uses while limiting employer exposure to rapidly rising pharmacy claims. Opponents expressed concern about narrowing coverage for employees and emphasized the drugs’ potential medical benefits when prescribed by a clinician. After discussion, the council voted 4–1 in favor of the 8% renewal and the weight‑loss GLP‑1 carve‑out, with Mayor Pro Tim Ballou casting the lone dissent.
Next steps: staff will implement the selected renewal and related plan language. The city said employees who receive a GLP‑1 prescription for weight‑loss will retain the option to obtain the medication directly but would be responsible for the cash cost unless the prescription is for an approved diagnosis that keeps it eligible for coverage.
