Attachment B Health Plan Annual Report.pdf

The document is the Health Insurance Plan Annual Report for the Nebraska Department of Administrative Services (DAS), covering the plan year from July 1, 2023 to June 30, 2024, and presented to the Legislature's Appropriations Committee on November 19, 2024. The report provides a comprehensive overview of the state's health insurance program, which consists of five self-insured health plans: the Regular Plan, WellNebraska Plan, Consumer-Focused Health Plan (CFHP), and two Direct Primary Care (DPC) plans. These plans cover approximately 13,300 eligible public servants and their families, providing medical and prescription drug coverage for in-network and out-of-network providers, along with wellness benefits. Key highlights include implementing benefit improvements while keeping contribution rate increases below market level, enhancing maternity benefits, and introducing a Tri-Care Stipend program for eligible public servants with prior military service.

The report details the financial performance of the State Employees Insurance Fund #68960, which received $213.4 million in contributions and had total medical claims of $191 million for the fiscal year. The state pays 79% of monthly rates, with active full-time public servants paying 21%. The health insurance program saw a 1.9% increase in covered lives to 27,580, with 55.6% female and 44.4% male participants, and an average member age of 35.1. Notable changes for the 2023-2024 plan year include eliminating the $500 copay for maternity services in the Wellness plan, expanding UHC's Preventive Drug List, and increasing physical and occupational therapy session limits. The report also highlights special programs like the Real Appeal weight loss program and maternity benefits, and announces the termination of both DPC plans effective July 1, 2024, due to low enrollment and utilization. Looking ahead, the state anticipates 4% contribution increases for WellNebraska, Regular Health Plan, and Consumer-Focused Health Plan in the 2024-2025 plan year.