Attachment B Health Plan Annual Report.pdf

This is an annual health insurance plan report from the Nebraska Department of Administrative Services (DAS) presented to the Legislature's Appropriations Committee for the plan year July 1, 2023 to June 30, 2024. The report details the state's self-insured health plans which provide medical and prescription drug benefits to approximately 13,300 eligible public servants and their family members, covering 27,600 lives overall. The health insurance program consists of five self-insured plans: Regular Plan, WellNebraska Plan, Consumer-Focused Health Plan (CFHP), and two Direct Primary Care (DPC) plans, administered through United Healthcare (UHC) with pharmacy benefits managed by OptumRx. Key changes for 2023-2024 included decreasing medical copays by $10, eliminating the $500 maternity copay for Wellness plan participants, expanding preventive drug coverage, and increasing therapy visit limits.

The total state investment in the Health Fund for 2023-2024 was over $167.2 million, representing 12% of a $1.4 billion total rewards portfolio. The state pays 79% of monthly premiums while employees pay 21%. Total medical claims paid were $191 million, with pharmacy claims at $69.7 million. The fund experienced a net decrease of $21.9 million for 2023-2024, with the total reserve fund balance declining 32% to $47.2 million. Future changes include a 4% premium increase for 2024-2025 across all plans, termination of the DPC pilot program, and continued focus on specialty drug management and diabetic health initiatives.