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20 <br /> 1 Travis Myren reviewed some of the methods for reducing health insurance costs, including <br /> 2 a direct-to-consumer pharmacy benefit. <br /> 3 Vice-Chair Fowler said that the state health plan stopped covering GLP-1 drugs. She said <br /> 4 a middle ground option could be considered by the county. <br /> 5 Travis Myren said, in theory, they will reduce the county's overall health costs. He said <br /> 6 there is also an indication that GLP-1's can affect sleep apnea. <br /> 7 Vice-Chair Fowler said it is difficult to stop GLP-1s once you begin taking them. <br /> 8 Chair Hamilton asked if the county would put all drugs in the direct-to-consumer plan. <br /> 9 Travis Myren said they would start with GLP-1 s and then see if other drugs would be a <br /> 10 good fit. <br /> 11 Chair Hamilton asked for the tradeoffs for changing co-pays and other health benefit <br /> 12 parameters. <br /> 13 Travis Myren said the county is in the NC Health Insurance pool, and Gallagher is the <br /> 14 administrator. He said they give the county data on the possible disruptions that changes would <br /> 15 cause. <br /> 16 Commissioner Carter asked if there are other counties that are doing direct-to-consumer. <br /> 17 Travis Myren said there are other employers using the direct-to-consumer pharmacy card, <br /> 18 but he wasn't sure about counties. <br /> 19 Commissioner Bedford said she was glad that the psychiatry costs are up because it <br /> 20 indicates that employees are using the benefit. <br /> 21 <br /> 22 Slide #15 <br /> FY 2026-27 Expenditure Budget <br /> Local Government Employee Retirement System <br /> Historic and Projected LGER5 Contributions <br /> Both the employee and the employer contributes a percentage of <br /> ,,ie.asa <br /> salary AM% r1622%A,c <br /> Employee contribution is fixed at 6% 15,10% uslx <br /> 14.oax 1a.35w <br /> County rate is set each year by the LGERS Board 12.62. <br /> u esw <br /> 12.00x <br /> 11.33x <br /> County percentage has nearly doubled since 2019 <br /> 1o.00x sW.ls% <br /> FY2026-27 Budget would need$5:5 million less if contributions were at the e.9sx <br /> 2019 rates. <br /> 6.awc <br /> Most recent actuarial estimates project that county contribution will x019 20x0 2021 x022 2023 2024 x025 20x6 2027 x028 2029 2039 <br /> continue to increase through FY 2029 Yro; R o' <br /> -lOCR3{ontntrutlm =--Projeclyd <br /> ©RANGE (ZOUNTY <br /> 15 NORTH CAROLINAS <br /> 23 <br /> 24 Commissioner Greene asked what is expected to happen in 2030 that will make the <br /> 25 contribution increase go down. <br /> 26 Travis Myren said this is based on actuarial studies. He said there is likely something that <br /> 27 changes the pool at that time that will make the increase lower. <br /> 28 <br /> 29 <br />