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Shawnee County approves Blue Cross change to pharmacy coupon handling for high-deductible plan
Summary
The county approved contract C440-2025 with Blue Cross Blue Shield to replace an "accumulator adjustment" with a new "flex access" program for the high-deductible health plan; the change affects how manufacturer pharmacy coupon values are captured and whether they count toward deductibles and out-of-pocket totals.
The Shawnee County Board of County Commissioners on Dec. 1 approved contract C440-2025 with Blue Cross Blue Shield that adds a "flex access" program for the county's high-deductible health plan.
Angela Lewis, director of administrative services, told commissioners that there are no changes to administrative rates, plan deductibles or coinsurance levels but that the new program replaces the existing "accumulator adjustment" and applies only to the county's high-deductible plan. Brent Krennen of Blue Cross Blue Shield Kansas said the program is designed to "bring more awareness to the coupon values that exist for certain pharmacy drugs" and to ensure manufacturers' coupon dollars are handled consistently for plan members and the county plan.
Krennen said the program seeks to avoid crediting a member's deductible or out-of-pocket total for the value of a manufacturer's coupon when the member does not actually pay that amount. "If there was a $5,000 coupon and the member used it and we don't capture it, we give them credit for their $5,000 toward their deductible and out-of-pocket," he said. "This program is to make sure we don't give credit for coupon value that the member didn't truly pay."
Commissioners asked clarifying questions about whether Blue Cross is the pharmacy processor on the high-deductible plans (Krennen confirmed they are), and whether negotiated pricing is still applied when coupons are used (Krennen said it is). After discussion, Commissioner May moved to approve the contract; the motion was seconded and passed unanimously, 3-0.
The contract change was presented as administrative: county staff said it aims to manage plan cost and to equalize members' out-of-pocket experiences rather than change benefit levels. The board did not discuss any changes to eligibility or plan design beyond the coupon-handling program.
The county clerk recorded the approval; the contract will be implemented under the county's existing health-plan arrangements.
