JBC-Employee Benefits Division - Oversight Subcommittee
Video
Transcript
3 documents
Machine transcript
May contain errors. Verify important quotations against the official video.
About transcript accuracy
- Source
- SliQ live captions
- Model
- SliQ live ASR
- Processing date
- October 2, 2026
Representative Jon Milligan
Unverified
1:38
Members get to your seats. We're gonna start right at 9:30 since everybody's got committee meetings at 10.
Cherry sees decorum and call the meeting to order. Appreciate everybody being here this morning,
uh. Do you have anything to say, Senator Sullivan, you'd like to add? OK. OK. Yeah, I know everybody's got a meeting at 10, so we'll try to get through this pretty quick. Uh, we're gonna ask Grant Wallace, director, to come up to the table and he's gonna explain it if you would, sir, you can go ahead and start with C1, the formularies, and we'll go from there, uh, Grant Wallace, director of Employee
Speaker 15
3:02
Benefits division, starting with C1. These are our normal formularies that you will Uh, in ALC review. So now you get the pleasure of doing so today, um. One second. We'll start with the uh first one in your packet, that would be the January 2025 formulary recommendation. This is our pharmacy, uh, formulary, so ones that are administered through a, uh, pharmacy. You will see.
Most changes are related to quantity limits, um, or some tearing updates. There are some exclusions, uh, that are, uh, they're either new to market or we uh have a lower cost alternative already on the formulary. So are there any questions with uh January? Saying no questions, go ahead, sir. OK, moving on to February.
Same set up the February 2025 EBD formulary. These are the pharmacy recommendations. There's one that I do want to highlight, that's the Trintellix. We are excluding this one, we have found that there are other alternatives that are more effective, uh, the 96 members that are impacted are being um. put on a lifetime grandfathering, so they will not be, we don't want to change
anybody that is on this. We are just trying to move to other alternatives and not have any new starts with this particular drug. Um, The other larger change on this one is the, uh, Veramil Capsule at 360 mg. That one is excluding with a grandfather of 90 days, uh, there are other alternatives, uh, and. For them to utilize. So any questions on
Representative Jon Milligan
Unverified
5:09
That one. Yes, sir, I have one. Uh, Senator
Senator Jimmy Hickey, Jr
Unverified
5:15
Hickey, just, just so I know on the grandfather part that you're talking about, how, how does that exactly work? Is that if they have, uh, consecutive continued service, or what if they get off? Do they go back at that point or, or how does that work? Or have we thought about it? Right, so the grandfathering
Speaker 22
5:30
is anybody that's on it has 90 days to work with their provider to transition to something else. So if
Speaker 15
5:36
they, they transition quicker than 90 days, no, they're not allowed to, to
come back on. They just have a 90, up to a 90 day period to find an alternative medication to take. So 2 years from
Senator Jimmy Hickey, Jr
Unverified
5:49
now, if, if somebody is on that drug, they're grandfathered in. If I understand that correct, they go off of that drug. For 6 months. Can they then go back again or are they all, they're off. Fair enough. Thank you, sir.
Speaker 26
6:10
I don't see any more oh I'm sorry, you got one right here, rivers in the grams, go ahead.
Representative Zack Gramlich
Unverified
6:15
Uh, yeah, just a quick question and so with that, I mean, every drug that you're taking off there are already alternatives on the market. It's not like I'm, I had a, my father has a friend and it's not an ABD thing, but had a cancer drug they took off the market refused to, you know, take any anymore, and then there was nothing, so he's just out of luck so I just always want to make sure that there's another path for people to get care. Saying no more questions, go
Speaker 15
6:41
ahead. OK, the last one in this packet is the medical drug formulary for February 2025. Again, just a reminder, these are drugs that are administered in a clinical setting. So whether it is at a doctor's office or uh an IV infusion treatment center or anything along those lines. These are your more expensive cancer treating drugs, um, and, and those, you will see that a great deal of these are new to market, so we do exclude them until there is more clinical evidence
of the efficacy and value of adding them on, um, you will also see in there like the daxify, which is number. About 6 down, says cover with EBRXPPA. What that means is that the prior authorization will actually go through our consultant EBRX and the criteria is managed through them. The other option that you'll see is like uh Ruluco that says no EBRX restrictions, that would
actually just follow the health advantage protocol and aligns with FDA recommended coverage and protocols around those drugs. Be glad to answer any questions. Saying no questions. That wrap us up on C1.
Representative Jon Milligan
Unverified
7:58
Yes, sir. OK, members, we need a motion to approve, uh, see one, I have a motion, have a second, have a second in discussion on the motion. All in favor, say yeah, I'll oppose motion passes.
Uh, Mr. Walla, you go ahead with
Speaker 15
8:18
C2, OK, the next thing in your packet is a contract for your review, um, and I really wish I could come up with a different way to, uh, to name this company. I'm going to beg that we could do the target targey thing here, but I want to draw a clear distinction, uh, the contract you have before you is Navitas Business Solution with an A, not a U. They are not in any way related to the farm. benefit manager. This is a
different company that's in the technology space, uh, just unfortunately have a name that's a little bit too close to another company we work with. Uh, this contract is for our technology provider. They operate our AR benefits portal system, which manages not only our administrative aspect, but also the member facing portal and the portal that we work with with the uh health insurance representatives that are in the school districts and state agencies. This contract is for an initial 3 years. period at a value of 12 million
if it goes to the full 7, it would be 22 million, and I'd be glad to answer
Representative Jon Milligan
Unverified
9:26
any questions. Any question members also you can look on your coverle letter, it does, it,
it is spelled wrong. It's TUS it's supposed to be I, so that is too different. Uh, we are talking about the one on the back page, so do I have any questions? Senator Hickey Who
Senator Jimmy Hickey, Jr
Unverified
9:56
Now you're go ahead, just since we have to have approval on this review we have so I guess the motion whenever we do that, should we go ahead and have that motion that that that that is being changed because since that's on that sheet spelled wrong, I do think that we probably need that
Speaker 38
10:08
needs to be in the motion to correct it. It's just on the cover. No, sir, it's just
Speaker 26
10:18
on the cover letter. The contract is correct. OK, so the, the AS is the correct one on the contract that's correct. OK, so the out
Speaker 38
10:28
of state contract page, this one is correct. All right, that, that works. Thank
Representative Jon Milligan
Unverified
10:34
you. Any further questions? If not, I need to, I need the uh motion to review C2, have a motion, have a second. Any discussion? Not all in favor say a all oppose motion passes. Thank you, Mr. Grant. Appreciate it. uh, that is it for today. No more business. Thank y'all guys. And ladies.
Agenda
A. Call to Order
B. Comments by the Chairs
C. Review and Approval of Actions by the State Board of Finance -Grant Wallace, Director, Employee Benefits Division (EBD), Department of Transformation and Shared Services
D. Other Business
E. Adjournment
Documents
Speakers
Representative Jon Milligan
Unverified
Speaker 15
Senator Jimmy Hickey, Jr
Unverified
Speaker 22
Speaker 26
Representative Zack Gramlich
Unverified
Speaker 38