Attachment B Health Plan Annual Report.pdf

This is a Health Insurance Plan Annual Report for 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 insurance program which consists of five plans: Regular Plan, WellNebraska Plan, Consumer-Focused Health Plan (CFHP), and two Direct Primary Care (DPC) plans. The program covers approximately 13,300 eligible public servants and their family members, totaling 27,580 covered lives. Key changes implemented in 2023-2024 include a $10 decrease for medical copays, elimination of $500 maternity copay for Wellness plan participants, expansion of UHC's Preventive Drug List, and increased therapy session limits.

The Health Fund investment totaled over $167.2 million for plan year 2023-2024, representing 12% of the state's $1.4 billion total rewards portfolio. The state pays 79% of monthly premiums while active employees pay 21%. Medical claims paid amounted to $191 million in fiscal year 2023-2024, with pharmacy claims totaling $69.7 million. The program saw a 1.9% increase in enrollment from the previous year. Notable metrics include an 83.9% generic drug utilization rate and a 4.5% high-cost claimant population responsible for over $106.4 million in claims. The DPC pilot program will be terminated effective July 1, 2024, due to insufficient utilization compared to monthly fees. Future plans include a uniform 4% premium increase for 2024-2025 across all plans and continued focus on specialty drug management and diabetic health initiatives.