Group Benefits Policy and Planning Board public meetings in 2025

Group Benefits Policy and Planning Board

The OGB Policy and Planning Board and Estimating Conference are meeting to approve emergency contract amendments for 2026. The board will also consider a contract recommendation for an Individual Market Medicare Exchange Broker with Administrative Services for Health Reimbursement Arrangement.

• CaremarkPCS Health, LLC (CVS Caremark) Emergency Contract Amendment No. 2
• Peoples Health Emergency Contract Amendment No. 2
• Humana Health Plan of Louisiana, Inc. Emergency Contract Amendment No. 2
• HMO Louisiana, Inc. Emergency Contract Amendment No. 3
• Contract recommendation for Individual Market Medicare Exchange Broker (2026-2028)

Group Benefits Policy and Planning Board

The Office of Group Benefits Policy and Planning Board and Estimating Conference will meet to discuss procurement matters. The body is reviewing emergency contract amendments for several health organizations and an RFP for a Medicare exchange broker.

• CaremarkPCS Health, LLC (CVS Caremark) Emergency Contract Amendment No. 2
• Peoples Health Emergency Contract Amendment No. 2
• Humana Health Plan of Louisiana, Inc. Emergency Contract Amendment No. 2
• HMO Louisiana, Inc. Emergency Contract Amendment No. 3
• RFP for individual market Medicare exchange broker with administrative services

Group Benefits Policy and Planning Board

The OGB Policy and Planning Board and Estimating Conference will meet to discuss procurement matters and financial updates. The body will consider emergency contracts and amendments for 2026 and review premium rate change recommendations for self-funded plans for 2026-2030.

• Emergency contracts for 2026: CVS Caremark, Liviniti, and Blue Cross and Blue Shield of Louisiana
• Contract amendments for 2026: Buck Global, LLC, Humana Health Plan of Louisiana, Inc., Peoples Health, and HMO Louisiana, Inc.
• 2026-2030 Premium Rate Change Recommendations for Self-funded Plans
• RFPs for 2026: Fully-insured commercial HMO plans and individual market Medicare exchange broker
• RFPs for 2027: Medicare Advantage HMO/PPO plans and administrative services for self-funded medical plans

The OGB Policy and Planning Board and Estimating Conference met September 4, 2025 in Baton Rouge and approved a 7.75% increase in premium rates for self-funded plans for Plan Year 2026, after a substitute motion to repeat the 6.65% increase from 2024 failed on a roll call vote. The board also recommended emergency 2026 contracts for pharmacy benefit manager services with CVS Caremark and Liviniti, and an administrative services contract with Blue Cross and Blue Shield of Louisiana, and forwarded a two-year extension of the Buck Global actuarial services contract. Medicare Advantage contracts were presented for information only and no vote was taken; a later meeting will be scheduled to review them.

• Approved 7.75% premium rate increase for self-funded plans for Plan Year 2026 (passed without opposition)
• Substitute motion to repeat the 6.65% rate increase from 2024 failed on roll call vote (2 yes, 5 no, 1 left)
• Recommended emergency contract for CVS Caremark pharmacy benefit manager services (unanimous; two Estimating Conference members abstained)
• Recommended emergency contract for Liviniti pharmacy benefit manager services (unanimous; two Estimating Conference members abstained)
• Recommended emergency administrative services contract with Blue Cross and Blue Shield of Louisiana (unanimous; two Estimating Conference members abstained)
• Recommended two-year extension of Buck Global, LLC actuarial services contract (unanimous)
• Re-elected Mr. Frank Jobert as Chairman, Dr. Gwile Freeman as Vice Chairman, and Mr. Mike Saylor as Secretary (each unanimous)
• Approved minutes of the February 17, 2025 joint meeting (unanimous in both bodies)

Group Benefits Policy and Planning Board

The Office of Group Benefits Policy and Planning Board, combined with the Estimating Conference, will meet to discuss the issuance of a Request for Proposals for Pharmacy Benefits Manager services. The meeting will also include swearing in a new board member and approving prior meeting minutes.

• Discussion of Pharmacy Benefits Manager (PBM) Request for Proposals (RFP) Issuance
• Swearing in of new board member
• Approval of minutes from January 8, 2025 joint meeting

The board discussed the upcoming Pharmacy Benefits Manager (PBM) Request for Proposals (RFP) scheduled for release around March 10, 2025. Officials detailed the evaluation committee structure, the 30-day submission window, and the scoring process. No votes were taken on the RFP itself, as it is currently in the development phase.

• Approved motion to add swearing-in of new members to the agenda (unanimous)
• Swore in Emily Andrews and Brett Robinson to the Estimating Conference
• Approved January 8, 2025 Estimating Conference minutes (unanimous)
• Approved January 8, 2025 Policy and Planning Board minutes (unanimous)
• Approved motion to extend public comment time for Richard Vaughn (unanimous)

Group Benefits Policy and Planning Board

The Office of Group Benefits Policy and Planning Board, combined with the Estimating Conference, will consider procurement matters including contracts for Prudential (group term life) and Access Health, amendments for CVS/Caremark, Blue Cross/Blue Shield, and Buck Global, plus emergency contract amendments for three Medicare Advantage plans. The board will also discuss requests for proposals for ASO, PBM, and other services.

• Prudential Insurance Company of America (Group Term Life Insurance) contract
• Access Health Inc. (Access2day) contract
• CVS/Caremark Emergency Contract Amendment #1 – Medicare Prescription Payment Plan
• Louisiana Health Service & Indemnity Co. (Blue Cross/Blue Shield ASO) Amendment #4 – No Surprise Billing
• Buck Global Inc. Amendment #2 – Mental Health Parity and Addiction Equity Act

The Policy and Planning Board recommended several insurance and healthcare contracts for approval. Financial updates indicated the Office of Group Benefits (OGB) anticipates losing money in 2025 due to rising medical and pharmacy costs.

• Approved October 14, 2024 meeting minutes (Unanimous)
• Recommended Prudential Insurance Group Term Life contract (Unanimous)
• Recommended Access Health Inc. Primary Care Network contract (Unanimous)
• Recommended CVS Caremark Emergency Contract Amendment #1 (Unanimous)
• Recommended Blue Cross/Blue Shield ASO Amendment #4 to JUCB (Unanimous)
• Recommended Buck Global Inc. Amendment #2 (Unanimous)
• Recommended Medicare Advantage Emergency Contract extensions for HMO Louisiana, Humana, and Peoples Health (Unanimous)