Employee-Paid

California is trying to apply its new law to PBM efforts to serve self-insured employer health plans, as well as to PBM efforts to serve health insurers and government-run plans, such as public employee health plans.

U.S. Chief District Judge Richard Seeborg ruled last week that the courts should use North Carolina law when reviewing a worker's long-term disability insurance claim, not California law, because the insurer, Life Insurance Company of North America, made it clear that North Carolina law should apply.

For the government, the cost of an employer plan enrollee is about 37% of the cost of a Medicaid enrollee.

At the same time, several thousand new employees may be hired, according to news reports.

A new draft regulation would let employers offer the coverage through excepted benefits products.

The case could hinge on the details in a self-funded health plan's master services agreement.