On Wednesday, the State Health Benefits Program Plan Design Committee held its regularly scheduled May meeting.
While no specific actions were taken, the committee received several updates on topics regarding the rate setting for Plan Year 2025 including:
- Horizon Specialty Pharmacy update on cost of injectable drugs.
- Optum Formulary Update.
- Discussion and review of Annual Resolutions and cost impacts to employees and employers if readoption does not occur.
- The Inflation Reduction Act impact on plan design and costs.
- New laws that impact plan design, including P.L.2023, c.275 regarding the use of hearing aids and cochlear implants for covered lives under the age of 18 and P.L. 2023 c.258 regarding fertility treatments and the additional plan costs.
- Updates from the Division, Reference Based Pricing/Centers of Excellence subgroup, and the Super conciliation subgroup.
There was no specific discussion of potential rates for Plan Year 2025, which are anticipated to increase based on the State Treasurer’s budget testimony. Plan Year rates are usually adopted during a special meeting in July.
Contact: Paul Penna, Senior Legislative Analyst, ppenna@njlm.org, 609-695-3481, x110.