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4 <br /> CURRENT PBM RxSaveCard <br /> Drug Dose Estimated Employee Direct Price OC Subsidy Employee <br /> Insurance Price Monthly monthly <br /> (after rebate) Cost(PPO) cost <br /> Wegovy(inj) all $950 $25 $350 $375 $0 <br /> Zepbound (inj) low $850 $25 $299 $375 $0 <br /> Zepbound (inj) mid $850 $25 $399 $375 $24 <br /> Zepbound (inj) high $850 $25 $449 $375 $74 <br /> Wegovy(oral) low $800 $25 $149 $375 $0 <br /> Wegovy(oral) mid $800 $25 $249 $375 $0 <br /> Wegovy(oral) high $800 $25 $229 $375 $0 <br /> • The only drug for which the employee would have to contribute is for the Zepbound <br /> injectable at medium and high doses. Those prescriptions would carry an employee <br /> responsibility of $24 and $74 respectively. The current co-pay under the County's current <br /> plan is $25. <br /> 2. Implement a Surcharge for Spousal Health Insurance Coverage when Alternative <br /> Coverage is available to the Spouse <br /> • Implement a $200 per month surcharge to the employee contribution for spousal coverage <br /> when spouse has health insurance coverage with their employer. <br /> • Currently, 144 spouses are enrolled in the County's health plan. Staff from the North <br /> Carolina Health Insurance Pool (NCHIP) estimate that 20% of spouses or approximately <br /> 29 spouses would choose to remain on the County plans despite having alternative <br /> coverage. <br /> • If those employees were charged an extra $200 to maintain spousal coverage, direct <br /> revenue to the plan would increase by $70,000. <br /> Below is a chart showing the estimated direct financial impact: <br /> Spousal Surcharge Modelin <br /> Current Covered Spouses 144 <br /> Estimated % w Other Coverage 20% <br /> Monthly Surcharge Amount $200 <br /> Estimated Spouses Impacted 29 <br /> Estimated Surcharge Revenue $69,120 <br /> Surcharge Revenue Offset $69,120 <br /> • The spousal surcharge may also have an indirect savings to the plan by discouraging <br /> migration to the County's plan from coverage available to the spouse of a County <br /> employee. The County currently contributes an additional $600 per month to move <br /> from an employee only plan to an employee plus spouse plan and an additional $800 <br /> per month to move from an employee plus children plan to a full family plan. <br /> Discouraging migration to the County plan has the potential to save the additional <br /> County premium contribution associated with coverage a spouse as well as the <br />