Important 2025 Benefits Updates

Premiums

Benefits Administration strives to offer a wide choice of benefits while keeping premiums affordable. In 2025, health insurance premiums are increasing due to general inflation and the increased cost of delivering health care.

  • State and higher education active members and retirees: Health insurance premiums will increase by an average of 5.5%.
  • Local education active members and retirees: Health insurance premiums will increase by an average of 5.9%.
  • Local government active members and retirees: Health insurance premiums will increase by an average of 1.6%.

Specific premium increases will vary slightly depending on the health plan, network and coverage tier you choose. Your premium is automatically deducted from your paycheck each month.

  • Dental premium changes: Cigna Dental Health Maintenance Organization - Prepaid Provider rates will increase by 3.5% for active employees and retirees. Delta Dental DPPO plan rates will increase by 1% for all plan members.
  • Vision benefits and premiums will stay the same.

 

Flexible Benefits (central state/higher education employees only)

  • Central state/higher education employees only: Medical flexible spending account and limited purpose FSA contribution and carryover amounts are changing for 2025. You must re-enroll in these accounts every year.
  • Central state employees only: The transportation and parking FSA amount is also changing. You can enroll in these accounts at any time by submitting a paper form.

 

Benefits

There are no vendor changes for 2025. All member health plan cost sharing, such as deductibles or coinsurance, will stay the same except for the following changes:

  • A third non-preferred brand drug specialty tier will be added to the Preferred Provider Organization options. Pharmacy benefits currently have two cost-sharing tiers for specialty medications - generics and brands.
  • The copay for Talkspace will be lowered to $15 for the PPO options. Talkspace lets members communicate with a therapist by audio or video from a smartphone or desktop. Currently, Talkspace visits under PPO plan cost the same as an in-network primary care office visit.

Additional changes approved by the insurance committees on Sept. 26, 2024:

  • Allergy serum and allergy injections will now be subject to an office visit copay or the lesser allowed amount on all Preferred Provider Organization plans. This is a change from current benefits where costs for allergy serum apply to the deductible with coinsurance and there is no cost for allergy injections. This should reduce the cost burden for most members over the course of the year. Please note, Consumer-driven Health Plan members will continue to pay deductible with coinsurance.
  • Enhanced maternity benefit coverage will be provided on all plans. The enhanced benefit offers short-term coverage for the first 31 days of a newborn child’s life, if: (1) the head of contract or spouse is a covered person at the time of giving birth to the child; (2) the HOC did not enroll the child on the plan as a dependent; and (3) the HOC did not decline the enhanced benefit. The change can be found in Section 12.03 (C) of the 2025 Plan Document and does not alter the head of contract’s responsibility to enroll a newborn for dependent coverage beyond 31 days.

Please refer to the Insurance Comparison Charts and the Plan Documents on the Publications page of our website for more details.

New in 2025! Benefit change for CDHP members: Anti-obesity medications will no longer be on the preventive drug list for the CDHP option in 2025. Members enrolled in this plan will be subject to their plan’s deductible before plan coverage begins for anti-obesity medications including, but not limited to, Qsymia, Wegovy, Zepbound and Saxenda.

 What this benefit change means for CDHP members starting Jan. 1, 2025:

  • Members enrolled in the CDHP must meet their plan’s deductible before coverage begins for anti-obesity medications including, but not limited to, Qsymia, Wegovy, Zepbound and Saxenda. 
  • Members who meet certain prior authorization criteria can still get these drugs covered. The only difference will be how much they pay.
  • Anti-obesity drugs are NOT being removed from coverage.