Pharmacy program review highlights potential savings but faces Cigna contract limitations

Rockingham County's Board of Commissioners convened on April 3, 2025, to discuss key updates regarding the county's health insurance plans and pharmacy benefits, with a focus on cost management and potential savings for the community.

One of the primary topics was the performance of the county's health plans. The low plan is currently performing well at 59%, while the high plan has seen a decline, now at 9.6%. Year-to-date figures indicate a slight increase in costs, prompting discussions on potential adjustments to the high plan to better align with budget expectations.

A significant proposal discussed was the introduction of a pharmacy benefit manager program, which could potentially save the county between 15% to 25% on pharmacy spending. However, the feasibility of this program is hindered by existing contracts with Cigna, which restrict participation to larger groups. The current pharmacy plan is noted to have strong discounts, making any transition challenging due to possible disruptions in medication access for members.

The commissioners also explored the implications of a spousal surcharge and opt-out credits for employees, noting that while these practices are not widely adopted, they could enhance the county's benefits strategy. The meeting concluded with a commitment to further analyze the pharmacy benefits landscape and explore alternative options for the county's health plans.

As the county moves forward, the Board aims to refine its health insurance offerings while ensuring that any changes do not adversely affect employees' access to necessary medications and services. The next steps will involve gathering more data and preparing recommendations for future meetings, with the goal of optimizing health benefits for Rockingham County residents.