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The original item was published from 7/28/2023 2:16:00 PM to 7/28/2023 4:09:52 PM.

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Emergency Management & Public Health

Posted on: July 28, 2023

[ARCHIVED] State Health Benefits Plan Design Committee Meets

The State Health Benefits Program Plan Design Committee convened on July 26, 2023. The meeting focused on the issue of rising service costs, identified as the main factor for the uptick in state health benefits expenses. To address this and other issues, the committee passed nine resolutions for the 2024 Plan Year.

The resolutions include:

  1. RESOLUTION 2023-2: Reduction in Specialty Copay
  2. RESOLUTION 2023-3: Formulary Management and Out of Network Physical Therapy
  3. RESOLUTION 2023-4: Mail Order Incentive and $0 Copay for Generic Mail Order Prescription Drugs
  4. RESOLUTION 2023-5: Generic Substitution Preference
  5. RESOLUTION 2023-6: Copay Reduction for Retiree Mail Order Preferred Brand Prescription Drugs
  6. RESOLUTION 2023-7: Tiered Network Plan Financial Incentive Pilot Program.
  7. RESOLUTION 2023-8: Point Solutions
  8. RESOLUTION 2023-9: Reference Based Pricing
  9. RESOLUTION 2023-10: Medical Specialty RX

The committee also embarked on a discussion about Health Reimbursement Arrangements (HRA), exploring various strategies to make these arrangements more beneficial for the members.

A Super conciliation update was provided to keep the members informed about ongoing efforts to reconcile any discrepancies and errors in the enrollment and billing processes.

The meeting was adjourned following these productive discussions and passage of resolutions. The committee is eager to see the positive impacts of these changes on the State Health Benefits Program.

Contact: Andrew LaFevre, Legislative Analyst,, 609-695-3481, x116.

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