Breaux Bridge – The St. Martin Parish School Board heard a proposal to shift its retiree prescription plan from its self-pay option to a Humana Prescription Drug plan during its finance committee meeting this past Wednesday.
The move would save the school system nearly $1 million annually, the school board was told by Stacey Bienvenu of Brown & Brown Insurance, who is the account manager for the school system’s health plan.
The school system selffunds its health care coverage for employees with prescription coverage managed through Liviniti (formerly Southern Scripts).
Beginning in 2021, retirees ages 65 and older who are on Medicare Parts A and B were allowed to opt either to stay with the Liviniti plan or move to the United Healthcare Medicare Advantage Plan if they preferred that, Bienvenu told the board.
The school system and Brown & Brown held several meetings at the time for retirees to attend to go over the options. The UHM plan included lower premiums for members to pay as well as added benefits of dental, vision and over-the-counter medicine coverage. The premiums are $399 per month for retirees and their spouses, which has gone up a little effective Jan. 1. That cost to the school board averages about $1 million a year less for the school board than covering the cost of prescriptions for the retirees, Bienvenu said.
“That has been working really well,” Bienvenu said.
In 2022, the school board went to the Rx Compass program though Liviniti, which goes through seven different pathways to save cost on prescriptions, including getting prescriptions mailed from overseas, which is about one fourth of the cost for the same prescriptions from pharmacies in the U.S.
“That too in itself is saving probably between $800,000 and a million per year by using those pathways,” Bienvenu said.
About 399 retirees and their spouses who opted to stay with the school system’s self-funded plan, and 280 of those are eligible for Medicare Plan D (prescription drug plan).
“At the end of the day those 280 members, we would move them to the Humana plan,” Bienvenu said. “They would no longer be on your self-funded Liviniti plan. They would be fully insured instead of self-insured, for prescriptions only.
Prescription
“What would happen is those 280 members would move to the Humana Part D plan. Looking at the Humana quote and what the spend is under the Liviniti plan, it would save the school board close to a million dollars a year, with just prescriptions for those 280 members.”
There would be very little disruption for the retirees, she said, because they would still use their same pharmacies, just with a different insurance coverage card. Currently members have one card for health coverage and prescriptions. They’d keep the same health coverage card but have a separate card for prescription coverage under Humana.
The UHC plan will also have separate cards for prescription coverage beginning in January, so the school board and Brown & Brown are planning to let all pharmacies in the area know beginning in November or December that new prescription cards will be issued to school employees and retirees in January. For those who forget to bring their insurance card to the pharmacy, the pharmacy will have the plan number already in its system and only have to ask the insured person’s Social Security number to check for coverage.
The school board’s selfinsured plan pays $1.8 million a year for prescriptions for its retirees. The premium the school board would pay Humana for its Medicare Part D prescription plan would be $164.05 a month per member, or $551,000 annually, with no other costs.
The school board also pays $3.75 per prescription filled through Liviniti, another $184,000 per year. The legislature also passed a bill this year that adds another $11.81 dispensing fee per prescription at local pharmacies, adding up to another $30,000 per year in savings.
However, the school board would lose the money it gets from rebates and Retiree Drug Subsidy (RDS) from the federal government for prescriptions, which is about $558,000 a year.
“If I do all the math and everything stays about the same, it’s still about a $969,000 savings to St. Martin Parish School Board to move these members to the Humana Part D plan,” Bienvenu said.
Without the move to Humana, costs would likely go up for all insured people under the school board’s self-funded system, employees and retirees alike, she said.
“This would be the least amount of people affected and I don’t think there would be much disruption except for them having to give that second card,” Bienvenu said.
Maximum out of pocket cost would be $2,400 per year for prescription copays under the Humana plan.
Jennifer Borkowski of Humana briefly spoke via a video call. Borkowski said more than 11,000 drugs have been prescribed to SMPSB retirees and employees this year, and 98.1 percent of those are covered under the Humana plan. Most of the ones that weren’t covered were for coughs and colds, vitamins, folic acid and other similar items. Humana reran a quote that would include those drugs, and that brought the coverage to 100 percent.
Copays would be $15 (for preferred generics), $40 (non-preferred or standard generics), $70 (preferred brand name drugs) and $70 (nonpreferred brand-name or high-cost generics), all of which are applied to the $2,400 maximum out of pocket annual amount.
Board member Mark Hebert asked what backup plans would be in place if a drug is not covered under the plan.
Bienvenu said other options can sometimes be found through Good Rx or purchasing through Walmart, both of which sometimes have $4 generic versions of drugs. Humana also would double-check to see if prior authorizations are needed that would then qualify the drug for coverage, or check for other alternatives like Good Rx, Borkowski said.
Board member Richard Potier disputed Bienvenu’s numbers, saying changing to Humana would not save $1 million a year because the board would be paying $164.05 per month per retiree or spouse and the copay for retirees is being included in the money that is being claimed as savings.
“It sounds good but if you listen real good it ain’t that good because it’s a big increase on the board,” Potier said.
“But it’s not,” Bienvenu said. “It’s really a savings of a million dollars.”
“Hey, I do math,” Potier said. “You’re talking to them (pointing to other board members) but you can’t to talk to me that way. I’m seeing the figures. You know, there’s no way you’re going to tell us we’re going to get a savings. Yeah, the employees are going to get a savings. But the board is going to have an increase as far as paying for each employee.
School system Chief Financial Officer Casey Broussard said that the board pays Liviniti over $5 million a year for prescriptions including $1.8 million for retirees and their spouses. That nearly $2 million would no longer be coming out of the school board’s pockets, far offsetting the $551,000 total premium for Humana’s prescription plan, she explained.
“If you take this population (the retirees) and no longer have to cover the cost of their drugs, which they’re the highest on our plan, then we’re not going to pay that in claims, so it’s better to pay a flat amount,” Broussard said.
Potier argued that employee copay was included in the savings. Bienvenu said that was not the case. The copay remains the same whether under the self-funded plan or the Humana plan.
Broussard said that is not included in the board’s payments, only what it pays to Liviniti.
Finance Committee The board heard a recommendation from Operations and Transportation Supervisor John Chevalier to purchase five regular buses for $791,839.55 ($158,365.91 per bus) and three SPED buses for $468,423 ($156,141 each), all air-conditioned, from Blue Bird Buses. Total cost would be $1,360,353.55.
All buses are in-stock and come with a $3,500 discount per bus if purchased before Jan. 1.
The school board bought five regular buses and two SPED buses from IC Bus (International Motors) this past year for a total of $959,479.23 ($135,481.89 per regular bus and $146,034.89 per SPED bus), but those are difficult for mechanic’s to work on and take six months to build after being ordered.
Star Services also proposed a trial period to provide maintenance and repair services for HVAC systems at 10 schools in the district. The finance committee voted to table a decision for a month to allow the board president and Superintendent Frederick Wiltz to negotiate a deal with Star Services for the trial period.
Board member Steve Fuselier also discussed not paying full-time employees the full 40 hours pay if they do not work the full 40 hour work week under the board’s four-day work week plan for those employees in the summer. Some employees are scheduled for four 10hour work days instead of five eight-hour days.
Consent Agenda
The consent agenda passed by the board included designating Oct. 18-24 as National Character Counts Week and designating Oct. 24-3 as Red Ribbon Week.
In Other Business
Crystal Rapachuk, the Magnet Schools coordinator, was honored as the Southern Scripts Employee of the Month.
