The California Public Employees Retirement System (CalPERS) votes today on a recommendation calling for a 6% increase in premiums and a change in co-payments for office visits and prescriptions.
The Health Benefits Committee has recommended a health premium package to the Board of Administration which includes:
- a line up of eight health maintenance organizations (HMOs)
- a 6% premium increase
- a future enrollment freeze for Health Net, one of the system’s largest carriers
- an increase to $10/office visit copay from $5/visit
- changes in prescription drug copays
If adopted by the Board of Administration tomorrow, the package would cost $1.758 billion, compared to $1.65 billion for the 2001 rates.
The prescription drug plan was modified to encourage the use of generic drugs and mail order purchasing. It also aligned the HMO benefit with the CalPERS preferred provider organizations, which switched to the three-tiered benefit earlier this year.
Under the proposed three-tier prescription drug plan, members purchasing a 30-day supply from retail pharmacies would pay:
- $5 for generics
- $10 for brand name drugs
- $15 for nonformulary drugs
Those who purchase 90-day prescriptions by mail would pay
- $10 for generics
- $15 for brand name drugs
- $30 for nonformulary drugs
Currently, members pay a $5 copay on all prescriptions.