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Lancaster County adopts changes to employee health plan, citing rising medical and pharmacy costs
Summary
The Lancaster County Board of Commissioners unanimously approved health-insurance plan changes after a HUB International presentation outlining rising medical and pharmacy trends and targeted cost-control proposals, including pharmacy management tactics and a proposed Bryan Health direct-network discount.
The Lancaster County Board of Commissioners voted 5-0 July 30 to adopt changes to the county's group health and dental plans after a presentation from HUB International.
Dennis Meyer, Budget and Fiscal Officer, opened the discussion by noting "the proposed budget includes a 12% increase in health insurance and dental insurance rates." Sandy Ryan of HUB International said the changes respond to cost trends: "medical costs are increasing by approximately 9% and pharmacy costs by about 12%," and outlined several targeted initiatives intended to control costs while minimizing broad benefit reductions.
HUB's proposals include dermatology clinical pharmacy management with quantity limits, step therapy, and prior authorization for certain high-cost topical medications; encouraging mail-order use by increasing the effective retail 90-day copay from one 30-day copay to two 30-day copays (while keeping mail-order pricing unchanged); encouraging generics; and transitioning the County from a basic formulary to a standard control formulary to capture greater manufacturer rebates. Ryan estimated the retail copay change could save about $75,000 annually by shifting utilization to mail order.
Ryan also proposed a direct network agreement with Bryan Health that would reduce the deductible from $600 to $400 for services received at Bryan facilities, and a preferred centers program for hip, knee and spine surgeries that would waive deductibles for qualifying procedures. She noted the County's largest provider by utilization is Bryan and said a direct-network arrangement would encourage in-network use.
The presentation closed with a proposed Verda diabetes management program focused on coaching, medication management and incentives; Ryan said the county would pay only for employees who actively participate and projected savings based on a 25% participation rate. Meyer recommended the board decide on the Bryan direct-network portion soon to allow time for contract negotiations and member communications ahead of open enrollment.
The motion to adopt HUB International's proposed plan changes was made by Matt Schulte, seconded by Chelsea Johnson, and carried 5-0.
How this matters: the board's action locks in plan design changes and a rate path that county staff said will be reflected in open-enrollment materials later this summer. Officials emphasized the approach favors targeted management strategies over broad benefit cuts.
