Wellmark will be sending formulary changes notices effective July 1st, 2022. Formularies dictate how and what prescriptions are covered. This change will mostly affect the specialty drugs that have extremely high prices. Please keep an eye out for this.
Wellmark Blue Cross has requested the following rate increases for the 2023 plan year from the Iowa Insurance Division:
- Wellmark BCBS of Iowa PPO Pre-Affordable Care Act Plans: 4.5%
- Wellmark Health Plan of Iowa HMO Premier Affordable Care Act Plans: 7.8%
TRENDS IMPACTING PREMIUM INCREASES
Similar to prior years, this population continues to require more health care services to treat high-cost and complex conditions. While several factors add to the rate increase, the following are key drivers:
- A 7.2 percent increase in cost and use of medical services and prescriptions.
- A 9 percent increase in high-cost claimants — the number of members who have greater than $100,000 in claims increased.
- A 15 percent increase in retail pharmacy costs.