Open/Switch Enrollment for APS Employees is October 1 through 16
Albuquerque Public Schools
Effective July 1, 2026 New Medical Premium Rates
Medical Premium Rates, effective July 1, 2026, through December 31, 2026.
Definitions (coverage categories)
- Single: Employee
- Double: Employee + Spouse/DP or Employee + Child
- Family: Employee + 2 or more dependents
Employee Group Definitions (for benefit premium deductions)
- Bi-Monthly Employees = twice a month, 24 paychecks per year
Important Update Regarding Benefit Premiums: During the 2026 NM Legislative session, HB 47 was passed and signed by the Governor. Effective July 1, 2026, the cost-share for voluntary medical, dental and vision plan premium rates will be 80% APS and 20% enrolled employees. This means APS will pay 80% of the premium and employees will pay 20% of the premium, regardless of each benefits-eligible employee's annual salary. As of July 1, 2026, there will only be one premium rate for each medical, dental and vision plan coverage.
Twice a Month Payroll Deductions
Deductions for your medical insurance premium will come out of your paycheck on the 10th and 25th of each month. The amount you see below is what will be taken out of each paycheck.
Premium Rates For All Benefits Eligible Employees (EE 20% - APS 80% of Total Premium)
| Plan | Single | Double | Family |
|---|---|---|---|
| Blue Cross Blue Shield NM | $80.35 | $160.70 | $216.94 |
| Presbyterian Health Plan | $84.37 | $168.74 | $227.79 |
Express Scripts Prescription Drug Benefits
By enrolling in one of the APS medical plans, employees and dependents are automatically covered under the prescription medication program - Express Scripts. This program offers benefits through participating retail pharmacies and home delivery from Express Scripts Pharmacy and Accredo. For 2026, there are no changes to copays for preferred brand, non-preferred brand, or specialty medications. There are no changes to out-of-pocket maximums.
Important Notice: GLP-1 Medications for Weight Loss
GLP-1s (Glucagon-Like Peptide 1 receptor agonists) are commonly used to help adults with type 2 diabetes who are struggling to reach their A1C goals. They have recently grown in popularity for their potential to promote weight loss. To support eligible APS members with weight loss through the use of GLP-1 medication, a lifestyle modification program will be offered through Teladoc Livongo.
View the new GLP-1 medications for weight loss requirements. Once the eligible member has enrolled in the required lifestyle modification program for weight loss using a GLP-1 medication, a clinical prior authorization must be completed by a prescribing physician for a GLP-1 prescription to be processed and dispensed for weight loss. GLP-1 medications for weight loss will not be available to eligible APS members unless they remain enrolled in, participating in, and meeting the lifestyle modification program requirements. These requirements must continue to be met for GLP-1 dispensing and ongoing medication management for weight loss.
GLP-1 prescriptions (with an active prior authorization) may be dispensed for up to a 30-day supply at participating in-network retail pharmacies. Once stable on therapy, up to a 90-day supply of a maintenance dose may be dispensed through Walgreens or through Express Scripts GLP-1 dedicated home delivery pharmacy called Evernorth EnGuide SM Pharmacy.
There are changes to requirements for the use of GLP-1 medications for weight loss. If you are on a GLP-1 for weight loss or anticipate future use, please read the new prior authorization requirements.
Copayments/Coinsurance
Copays for generic, preferred brand, and non-preferred brand medications for 2026.
| Coinsurance |
Min (retail up to 34-day supply) |
Max (retail up to 34-day supply) | 90-day/home delivery or Walgreens | |
| Generic (no change) | 20% | $10 | $20 | |
| Preferred Brand Formulary | 30% | $50 | $100 | $150 |
| Non-Preferred Brand | 40% | $100 | $175 | $300 |
Specialty Medication Copays for 2026 (up to 30-day supply)
| Generic | Preferred Brand | Non-Preferred Brand |
| $100 | $125 | $200 |
Pharmacy Out-of-Pocket Maximums for 2026
| Employee Only | Emp. +1 | Family |
| $3,000 | $4,000 | $4,000 |
If you fill a prescription for a brand-name medication when a generic equivalent is available, you will pay the applicable copayment/coinsurance plus the difference in cost between the brand and the generic. The difference in cost will apply toward the out-of-pocket maximum.
If you need long-term medication, you are allowed two fills at an in-network retail pharmacy before you must move your prescription to a 90-day supply through Express Scripts® Pharmacy or Walgreens.
For more information about your Express Scripts benefits, go to express-scripts.com/aps.nm. Please refer to the complete Express Scripts Summary of Benefits for more detailed information, and for information and copayment amounts specific to specialty medications. Specialty medications must be filled through Accredo, the Express Scripts specialty pharmacy.