2027 Medical Premium Rates

Medical Premium Rates, effective January 1, 2027, through December 31, 2027.

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

For 2027, medical, dental, and vision premium rates will increase by 20.5%. We realize this is difficult for employees and families. As a reminder, 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 premiums is 80% APS and 20% enrolled employees. This means APS pays 80% of the premium and employees pay 20%, regardless of each benefits-eligible employee's annual salary.

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	$96.83	$193.65	$261.42
Presbyterian Health Plan	$101.67	$203.33	$274.49

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 2027, copays for preferred brand, non-preferred brand, and specialty medications will not change. There are no changes to out-of-pocket maximums.

Continuing: 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 also 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 is offered through Teladoc/Livongo.

View the requirements for GLP-1 medications for weight loss. An eligible member must enroll in the required lifestyle modification program, and their prescribing physician must complete a clinical prior authorization for a GLP-1 prescription. 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. Members must continue to meet these requirements for GLP-1 coverage and ongoing weight-loss medication management.

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, you may receive up to a 90-day supply of a maintenance dose through Walgreens or the Express Scripts GLP-1 dedicated home delivery pharmacy, EnGuide SM Pharmacy.

Requirements for using GLP-1 medications for weight loss have changed. 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 2027 (up to 30-day supply)

Generic

Preferred Brand

Non-Preferred Brand

$100

$125

$200

Pharmacy Out-of-Pocket Maximums for 2027

Employee Only

Emp. +1

Family

$3,000

$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 www.express-scripts.com/APSNM. Please refer to the complete Express Scripts Summary of Benefits for more detailed information, including copayment amounts specific to specialty medications. Specialty medications must be filled through Accredo, the Express Scripts specialty pharmacy.