(August 20, 2025) – Today, the State Employee Health Commission, chaired by Kansas Department of Administration Secretary Adam Proffitt, met. The committee discussed the existing wellness contract and response from other bidders including: Health By Design, Marathon Health and Vera Whole Health. The committee inquired about utilization rates for in-person versus virtual and total services, as well as concerns with access to physicians with the current vendor and their ability for same-day access.
Jennifer Fiory gave the committee a presentation on Medicare Advantage and Part D Rates for the upcoming calendar year. The committee learned that currently, 763 members are enrolled in a Medicare Advantage Plan. The program SilverScript is decreasing by 30 cents in year two of the two-year contract. Senator Beverly Gossage, who sits on the commission, emphasized that MA plans have zero premiums, and Kansas has a lot of agents who can help analyze employee options for MA plans, while reminding the group that these plans don't require underwriting. Senator Gossage expressed concern that the state plan lacks comparisons to other market plans and suggested further analysis of the statutes that mandate the state to offer these plans, rather than encouraging direct market participation. She indicated that most large employers have information available for beneficiaries about how to contact an agent to compare plans rather than a direct offer. She highlighted federal law changes on Part D Drug plan caps, and how they will increase premiums. Insurance Commissioner Vicki Schmidt noted that something similar has been done with long-term care plans and reminded the rest of the committee about the trial periods for Part D plans.
Secretary Proffitt and staff pointed out that links to healthcare.gov are currently available for employees to do comparisons. The committee agreed unanimously to the language changes following a motion by Senator Gossage to add language sending people to a local agent and a substitute motion by Insurance Commissioner Schmidt to include language to send people to all available resources.
The committee took up Employee Advisory Committee re-appointments of four members and received a financial report.
Next, Tracy Diel with the Kansas Department of Administration reported on the attorney general's settlement information related to an inquiry regarding rebates through Caremark. The AG hired an outside firm to review documentation, which determined that some payments received by Zinc Health Services constituted rebates that should have come back to the State Employee Health Plan. With a contractual obligation to return 100 percent of all rebate revenue in the contract, a settlement agreement was reached. Insurance Commissioner Schmidt asked which drugs were involved in this settlement, suggesting that the information is a part of contractual transparency. She questioned the timing, as the contract is coming up for review, and pointed out these are consequences of the larger vertical integration models. The committee asked if the added rebates are built into the projected costs going forward.
An executive session was held on the topic of attorney-client privilege regarding bid protests. The committee voted unanimously not to accept the bid protest.
The committee will meet next on Dec.18.