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Officials told most prescriptions would be unaffected if Seward County switches formularies
Summary
The broker said switching to the Results Rx formulary would leave about 94% of claims unchanged and disrupt roughly 6% of claim lines; staff emphasized Blue Cross will communicate changes and alternatives to members in advance.
County benefits staff and the broker discussed drug formulary design and the expected member impact if the county moved from its current select formulary to the Results Rx formulary.
Nick (IMA) said most current prescriptions would not be disrupted: "94% of the claims that have been filled this last plan year wouldn't be affected at all," he said, and added that roughly 6% of claims would be impacted either by a higher tier or exclusion. He further noted that about 80% of total utilizers would not be impacted, meaning a smaller share of members would see any change.
Presenters pointed out that many drugs falling off the plan may have over‑the‑counter alternatives or clinically appropriate substitutions and that Blue Cross would provide advance written notice so employees could work with providers on alternatives. The vendors also warned that moving formularies is one of several levers that can reduce pharmacy spend but may have uneven impacts across members depending on prescriptions.
