After postponing the July 29 State Health Benefits Commission Plan Year 2025 Rate Renewal meeting, which includes a proposed 17.2% increase for the Local Government Employer group, a meeting notice and agenda was posted this week for September 5 to consider the PY2025 rate renewal. As a comparison, the proposed rate increase for Plan Year 2025 for the State Employee Group is 11% and the Local Education School Education Health Program is 14.9%.
It is not yet known if the proposed Plan Year 2025 rate renewals will be affected by the recent adoption of the following actions of the Plan Design Committee at its July meeting:
- Adoption of Resolution 2024-07, which creates a Centers of Excellence (COE) Pilot Program to attempt to reduce the ever-rising costs of health and prescription drug benefits by bundling pricing, establishing transparent and predictable pricing, ensuring the demonstration of superior clinical outcomes versus national averages and versus the Third-Party Administrator (TPA’s) in-network providers.
- Inclusion of a new provision added to Resolution 2024-2 Formulary Management and Out of Network Physical Therapy permitting the reexamination.
- Allowing for a change of the formulary at any time to create a new formulary will save money for the plan, local government employers, and employees.
We will report on outcomes after the meeting.
Contact: Paul Penna, Senior Legislative Analyst, ppenna@njlm.org, 609-695-3481, x110.