ELMHURST, IL – Weight-loss drugs are helping cause the big increases in health insurance costs in Elmhurst School District 205, officials said Tuesday.
The school board has expressed frustration over continued Blue Cross Blue Shield hikes – 12 percent two years ago and 37 percent last year.
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Now, the company is proposing a 10 percent increase, with employees’ claims rising 12.7 percent in the last year.
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“Pharmacy and specifically weight-loss drugs remain a significant reason for the increasing healthcare costs,” Dr. Kelly Henry, a physician and school board member, said at a board meeting.
Under the proposal, pre-authorization would be required for weight-loss drugs and others, she said.
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“If a patient meets the medical criteria to receive this drug, it will be prescribed,” Henry said. “This will not have a negative impact on the health of our staff, but could help reduce costs for misuse of medications.”
Board member Kara Caforio said the district wants to provide good benefits for its employees. But she said the district is poised to enter its third year of double-digit rate increases. That is unsustainable, especially given the district’s budget deficit, she said.
For a particular weight-loss drug, one employee’s costs would total $16,800 a year, Caforio said.
“Then if you have 100 employees on that, that’s $1.68 million,” Caforio said. “We don’t know when that will end.”
The district’s consultant on health insurance said most of his company’s clients are going with pre-authorization for weight-loss drugs.
“Either physicians are prescribing (the drug) when they shouldn’t or members are going to great lengths to try and get their physicians to write these prescriptions,” said Brian Tyrrell of Alliant Insurance Services.
Caforio suggested the district’s insurance committee, which includes Henry and member Jim Collins, “go back to work and find a little more cost savings” with the insurance plan.
Member Kelly Asseff said she wasn’t ready for a vote on an insurance plan.
The board voted unanimously for a delay.
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