PREPARED BY: Nikki Swope
LB 158 DATE PREPARED: January 28, 2025
PHONE: 402-471-0042
Revision: 00
FISCAL NOTE
LEGISLATIVE FISCAL ANALYST ESTIMATE
ESTIMATE OF FISCAL IMPACT – STATE AGENCIES (See narrative for political subdivision estimates)
FY 2025-26 FY 2026-27
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS
CASH FUNDS
FEDERAL FUNDS
OTHER FUNDS
TOTAL FUNDS See Below See Below
Any Fiscal Notes received from state agencies and political su bdivisions are attached following the Legislative Fiscal Analyst Estimate.
LB 158 would require a health carrier or pharmacy benefit manager to include amounts paid by a health benefit plan enrollee or paid on
behalf of an enrollee by another person for the purpose of calculating the enrollee's overall contribution to any out-of-pocket maximum
or cost-sharing requirement under a health benefit plan. The bill has an enactment date of January 1, 2026.
LB 158 would require third- party co-pay assistance payments to be applied to health plan participants out-of-pocket copays prior to
offsetting plan costs. This would result in the reduction of co -pays paid by health plan participants but would result in increased health
plan costs.
Department of Administrative Services:
LB 158 would result in an estimated health plan increase of $900,000 per plan year to the State of Nebraska. However, the State of
Nebraska’s employee health plans utilize trust funds; thus, no additional appropriation is being requested.
The State of Nebraska pays 79% of the premium costs for healthcare plans and employees pay the remaining 21% thus the increased
cost is $355,500 in F Y 2025-26 for the partial year and $711,000 in FY 2026- 27. (79% of $900,000). Following is a breakdown of the
total cost by funding types:
Department of Administrative Services
Fund Type
Estimated Expenditures
FY 2025-26
Estimated Expenditures
FY 2026-27
General Fund $184,115 $368,230
Cash Fund $88,008 $176,016
Federal Fund $66,736 $133,471
Revolving Fund $16,641 $33,283
Total $355,500 $711,000
The impact of LB 158 would result in a health plan increase of $4,654 per plan year to the University. The University System pays 79%
of the premium costs for healthcare plans and employees pay the remaining 21% thus the increased cost is $166,848 in FY 2025- 26 for
the partial year and $33,696 in FY 2026-27. (79% of $42,654). Following is a breakdown of the total cost by funding types:
University Systems
Fund Type
Estimated Expenditures
FY 2025-26
Estimated Expenditures
FY 2026-27
General Fund $6,334 $12,468
Cash Fund $3,538 $7,076
Federal Fund $674 $1,347
Revolving Fund $6,402 $12,805
Total $16,848 $33,696
ADMINISTRATIVE SERVICES ST ATE BUDGET DIVISION: REVIEW OF AGENCY & POLT. SUB. RESPONSE
LB: 158 AM: AGENCY/POLT. SUB: Department of Administrative Services
REVIEWED BY: Ryan Walton DATE: 1/23/2025 PHONE: (402) 471-4174
COMMENTS: The Department of Administrative Service’s assessment of fiscal impact from LB 158, appears reasonable.
ADMINISTRATIVE SERVICES STATE BUDGET DIVISION: REVIEW OF AGENCY & POLT. SUB. RESPONSE
LB: 152 AM: AGENCY/POLT. SUB: Nebraska Association of County Officials
REVIEWED BY: Ryan Yang DATE: 1/15/2025 PHONE: (402) 471-4178
COMMENTS: No basis to disagree with the Nebraska Association of County Officials assessment of fiscal impact
from LB 152.
Please complete ALL (5) blanks in the first three lines. 2025
LB
(1) 158 FISCAL NOTE
State Agency OR Political Subdivision Name:
(2)
Department of Administrative Services (DAS) – Employee
Wellness & Benefits
Prepared by:
(3) Jennifer Norris Date Prepared:
(4)
01/14/2025 Phone:
(5)
402-471-4443
ESTIMATE PROVIDED BY STATE AGENCY OR POLITICAL SUBDIVISION
FY 2025-26 FY 2026-27
EXPENDITURES REVENUE EXPENDITURES REVENUE
GENERAL FUNDS
CASH FUNDS
FEDERAL FUNDS
REVOLVING
FUNDS
TOTAL FUNDS
See Below See Below See Below See Below
Explanation of Estimate:
LB 158 as introduced provides that for any health benefit plan entered into, amended, extended, or renewed on or
after January 1, 2026, a health carrier or pharmacy benefit manager is to include any amount paid by a plan
enrollee for purposes of calculating the enrollee’s overall contribution to any out-of-pocket maximum or cost-
sharing requirement under the plan.
Implementation of LB 158 would end the Accumulator Adjustment Program for the State of Nebraska medical
plans. Currently, manufacturer sponsored copay cards, coupons or rebates are applied towards pharmacy costs,
then the actual amount covered by the employee is applied towards the member’s deductible and out-of-pocket
maximum. Adding these outside payments allows the maximum to be reached sooner, leaving the State of
Nebraska to cover the costs over the maximum.
LB158 would increase the cost of the State of Nebraska medical plans by approximately $900,000 per plan year .
The State’s health plans utilize trust funds; thus, no additional appropriation is being requested.
As the State’s current medical plans are self-insured, an increase in claims would result in an increase in premium
costs. The State pays 79% of the premium and the employee pays 21%. The changes proposed in LB 158 would
impact the State’s and the employee’s premium costs.
The State’s estimated impact is $355,500 in FY25- 26 and $711,000 in FY26 -27. ($900,000 in estimated increased
costs x 79% = $711,000 ). The effective date of the bill is January 2026 – a partial fiscal year.
The table below summarizes the estimated impact by fund type of any premium increases. The allocation by fund
type is based on an average for Health Insurance expenditures over a five-year period (2020-2024).
Fund Type Expenditures –
FY25-26
Expenditures –
FY26-27
General Fund $184,115 $368,230
Cash Fund $88,008 $176,016
Federal Fund $66,736 $133,471
Revolving Fund $16,641 $33,283
Total $355,500 $711,000
_____________________________________________________________________________________________________ _
BREAKDOWN BY MAJOR OBJECTS OF EXPENDITURE
Personal Services:
POSITION TITLE
NUMBER OF POSITIONS
25-26 26-27
2025-26
EXPENDITURES
2026-27
EXPENDITURES
Benefits………………………………...……
Operating…………………………...……….
Travel………………………………………..
Capital outlay…………………...…………..
Aid…………………………………………...
Capital improvements……………………...
TOTAL……………………………… .....
0158Provide requirements for health carriers or pharmacy benefit managers
regarding out-of-pocket maximums and cost-sharing requirements
__________________________________
EXPENDITURESEXPENDITURES
NUMBER OF POSITIONS
Please complete ALL (5) blanks in the first three lines. 2025
LB
(1)
FISCAL NOTE
State Agency OR Political Subdivision Name:
(2)
University of Nebraska System
Prepared by:
(3)
Anne Barnes Date Prepared:
(4)
01/17/2025 Phone:
(5)
(402) 559-6300
ESTIMATE PROVIDED BY STATE AGENCY OR POLITICAL SUBDIVISION
FY 2025 - 26 FY 2026 - 27
EXPENDITURES REVENUE
GENERAL FUNDS
6,234.00 0.00
CASH FUNDS
3,538.00 0.00
FEDERAL FUNDS
674.00 0.00
OTHER FUNDS
6,402.00 0.00
TOTAL FUNDS
16,848.00 0.00
EXPENDITURES REVENUE
12,468.00 0.00
7,076.00 0.00
1,347.00 0.00
12,805.00 0.00
33,696.00 0.00
Explanation of Estimate:
The University of Nebraska self-insured employee health insurance plan utilizes third party co-pay assistance programs to offset prescription drug
costs to the health insurance plan. Legislative Bill 158 would require the third-party co-pay assistance payments to be applied to health plan
participants out-of-pocket co-pays prior to offsetting plan costs. This would reduce health plan co-pays paid by the health plan participants and
would increase plan costs. The fiscal impact is calculated based on calendar year 2024 activity. The total plan cost increase would be $42,654.
The University pays 79% of the premiums and employee pays 21% of the premiums for the health insurance plan. The total annual fiscal impact to
the University is $33,696 (79% of the $42,654 total annual cost). The requirements of the legislative bill would be on or after January 1, 2026.
BREAKDOWN BY MAJOR OBJECTS OF EXPENDITURE
Personal Services:
POSITION TITLE
Benefits..............................................
Operating...........................................
Travel.................................................
Capital outlay....................................
Aid...................................................
Capital improvements........................
TOTAL......................................
25 - 26
0
0
26 - 27
0
0
2025 - 26
16,848.00
16,848.00
2026 - 27
33,696.00
33,696.00