GVI Considers Cutting Weight Loss Drug Coverage as Health Plan Costs Surge to Near $191 Million
Facing a 17.5% proposed premium increase and escalating claims, VI officials may cut weight loss medication coverage and are encouraging participation in wellness programs to manage the $190.5 million projected cost of government employee health plans.
2025-06-27 13:21:09 - VI News Staff
Government employees in the U.S. Virgin Islands are likely to see higher health insurance premiums in the upcoming fiscal year, as medical claims continue to exceed plan revenues. The update was shared with members of the Committee on Budget, Appropriations, and Finance through a letter from the Government Employee Service Commission (GESC) Health Insurance Board of Trustees. The letter, which outlined the status of ongoing renewal negotiations with Cigna and United Healthcare, was read into the record by Cindy Richardson, director of the Division of Personnel.
According to Ms. Richardson, “both the vision insurance and the life and accidental death and dismemberment plans are in a pricing guarantee for the upcoming fiscal year, in which the premium rates will not change.” However, significant losses in other coverage categories are placing upward pressure on premium rates.
“Through May 2025 the medical claims expenditures are at 112% of the medical plan premiums,” the letter stated. Based on Cigna’s underwriting formula, such losses would typically result in a rate increase of more than 30%. While the insurer initially proposed a 24% increase based on March 2025 data, a later review conducted during a June meeting with the GESC Board found that claims had worsened, pushing the proposed rate hike to 26%.
After further negotiations, Cigna agreed to a 19.5% increase without any changes to plan benefits such as co-pays, deductibles, or out-of-pocket maximums. One proposed change could offer additional relief: ending coverage for weight loss medications, which “is costing more than it is saving.” Removing that coverage would reduce the premium hike by 2%, bringing it to 17.5%. “They further clarified that this increase is in line with our claims trending at a 17.7% increase for the current fiscal year,” Ms. Richardson told committee chair Senator Novelle Francis.