2025 Medical Premium Rates

Medical Premium Rates, effective January 1, 2025, through December 31, 2025.

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
C-Schedule/Food Services Employees = twice a month, 18 paychecks per year

NOTE: On January 1, 2025, APS will no longer offer Cigna Healthcare as a medical plan option. During Open/Switch Enrollment, employees with Cigna Healthcare coverage will need to select either Blue Cross Blue Shield of New Mexico (BCBS) or Presbyterian Health Plan (PHP). A comparison grid is available to review co-pays, deductibles, and out-of-pocket maximums.

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.

If you earn $60,000 or more.
(EE 40% - APS 60% of Total Premium)
Plan	Single	Double	Family
Blue Cross Blue Shield NM	$143.48	$286.96	$387.40
Presbyterian Health Plan	$150.66	$301.32	$406.77

If you earn $50,000 to $59,999.
(EE 30% - APS 70% of Total Premium)
Plan	Single	Double	Family
Blue Cross Blue Shield NM	$107.61	$215.22	$290.55
Presbyterian Health Plan	$112.99	$225.99	$305.08

If you earn less than $50,000.
(EE 20% - APS 80% of Total Premium)
Plan	Single	Double	Family
Blue Cross Blue Shield NM	$71.74	$143.48	$193.70
Presbyterian Health Plan	$75.33	$150.66	$203.39

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 2025, there are copay increases for preferred brands, non-preferred brands, and specialty drugs as well as an increase to the out-of-pocket maximum.

Please note the changes to copays for preferred brands, non-preferred brands, specialty drugs, and out-of-pocket maximums.

Copayments/Coinsurance

Copays for Preferred Brand Formulary and Non-Preferred Brand for 2025

	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 2025

Generic

Preferred Brand

Non-Preferred Brand

$100

$125

$200

Pharmacy Out-of-Pocket Maximums for 2025

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 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.

This page was last updated on: January 1, 2024.