Health plan claims rise; county sees large pharmacy rebate to be recorded next month

Health-plan staff reported to the committee on Jan. 9 that medical claims have trended higher in recent months while the overall plan remains under budget due in part to rebates from the pharmacy program.

Speaker 7 said the plan ended October up about 25% on medical claims, November about 20% and December stayed near 20%, while prescriptions have held at roughly 1% increase. “Overall, we're under budget about 4%, 649,000,” Speaker 7 said. He added the plan received a large pharmacy rebate—described as “over 1,000,000 dollars”—that was not yet reflected in the materials and will show up in next month’s statements.

Speaker 7 also reported heavy pharmacy volume in December and said pharmacy activity contributed materially to monthly variance. Committee members asked clarifying questions about timing and stop-loss activity; Speaker 7 described claims patterns as cyclical and said additional large payments are possible later in the fiscal year.

The committee moved to receive the report and approved it by voice vote. Speaker 2 asked that the document referenced by Speaker Wilkerson (Speaker 7) be added to the official record because it had not been attached to the agenda.