HomeMy WebLinkAboutHealth Plan Prescription Benefit Structure_SRKITTITAS COUNTY
BOARD OF COUNTY COMMISSIONERS
STAFF REPORT FOR
STUDY SESSION
Auditor
STUDY SESSION DATE: 10-07-2026
TOPIC: Health Plan Prescription Benefits — Evaluation of Potential Plan Changes
ACTION REQUESTED: Staff are seeking Board direction on whether to
implement one of the proposed prescription benefit cost -
saving models or maintain the current prescription drug
plan structure.
LEAD STAFF: Jeanne Killgore, Zack DeHaven
RECOMMENDATION: Staff recommend that the BOCC evaluate the three options
presented and provide direction to either maintain the current prescription plan structure
or select one of the two proposed changes and the corresponding cost savings.
BRIEFING SUMMARY: In anticipation of increased 2027 healthcare costs which are
currently estimated at 30%+, Alliant has provided two potential cost -saving models
related to the County's prescription drug plan. Depending on the model selected,
estimated savings would be approximately $30,000—$65,000 annually and would impact
approximately 250-300 members enrolled in the County's medical plans.
Advantage PDL
Essentials PDL
Summary
Same list of covered
medications, changes tiering
New, shorter list of covered
thatwill move drugs to a
medications
different copay level
Annual savings estimate
($31,635.00)
($67,800.00)
Memberlmpact
256members
298members
Tier 1 move to Tier 2
199 members will pay$35
205 members will pay$35
instead of $10
instead of $10
Tier 1 move to Tier 3
57 members will pay$70
67 members will pay$70
instead of $10
instead of $10
Move toTier 4
18will have a %cost share
NIA
instead of a copay
Exclusions
8will have medications
NIA
excluded (no longer covered)
The proposed increase would result in approximately $1 million in costs above the 2027
budget, with approximately $600,000 impacting the General Fund. Staff are actively
exploring additional alternatives to reduce the increase. This is the first option identified,
and Board direction is time -sensitive due to the upcoming benefits rollout.
Page 1 of 2
Auditor "Study Session Staff Report", 10/07/2026
ATTACHMENTS:
• None
Legal consultation? No
Finance consulted? Yes
Page 2 of 2
Auditor "Study Session Staff Report", 10/07/2026