St. Charles Parish board hears Humanana plan review, asks staff for cost‑sharing options ahead of renewal

Humanana presented the St. Charles Parish School Board with a 2025 Medicare Advantage plan pulse report on member experience, utilization and cost drivers, and the board asked staff and its broker to return with concrete options for plan design and cost sharing ahead of the upcoming renewal.

At the meeting, Jodie Hagewood, Humanana senior account executive, said the group’s net promoter score was 84.87 — “actually world class” and well above Humanana’s book average — and reviewed utilization and program engagement for the Jan. 1–Dec. 31, 2025 reporting period. The presentation documented a 19.6% increase in membership (153 additional members) after retirees transitioned from a UMR wrap plan to Humanana on Jan. 1, 2025, and showed strong preventive‑care engagement and higher primary‑care utilization.

The more urgent takeaway for board discussions was cost. Humanana reported a sharp pharmacy cost increase: pharmacy net paid per member per month rose to about $755 (a roughly 56% year‑over‑year increase), and specialty and high‑cost medications were driving a large share of the drug spend. Hagewood and Mia Basaraj, Humanana clinical pharmacy lead, attributed much of that upward pressure to federal changes under the Inflation Reduction Act (IRA), which lowered members’ out‑of‑pocket exposure and increased plan responsibility for high‑cost medications.

“Members reached the catastrophic phase at far higher rates in 2025 than 2024,” Basaraj said, noting that 274 members reached the catastrophic phase in 2025 versus 51 in 2024. Presenters also described large‑claim cases over $100,000 that rose from 18 to 31 and now account for a sizable share of medical spend.

Board members asked for actionable recommendations rather than raw data. John Smith pressed presenters for specific next steps: “What are you recommending that we do?” In response Humanana and USI said they would prepare an addendum of plan‑design options — including possible cost‑sharing scenarios, contribution strategies for retirees and spouses, and education materials to improve preventive screening uptake — once the official renewal and market proposals are available.

USI clarified data limits for the fully insured group: detailed claims data typically require larger group sizes (a detailed reporting threshold was described as about 3,000 members), so some analyses will be summarized at higher levels for the parish’s group. USI said it has solicited proposals from other Medicare Advantage carriers and will compare those bids to the renewal when it arrives.

The board directed staff to return with explicit options for the board’s consideration and discussed a potential August vote on any changes. The meeting closed after a motion to adjourn.

Next steps: Humanana and USI will provide the renewal details and a recommended menu of options for plan design, contribution strategies and member education for the board’s consideration before the renewal vote.