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Hoboken’s 2025 self-insurance costs finished 8% above fully insured equivalent rates, with medical and pharmacy claims totaling about $31.8 million for the year. Stop-loss reimbursements exceeded $1 million as prior-year claims continued through the runout period.
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The commission reviewed higher medical and prescription spending for 2025, including increased costs among individual claims and December claims of about $2.8 million. Claims incurred in 2025 may still be paid during 2026, and reimbursements could return money to Hoboken if claims exceed the $300,000 stop-loss threshold. Prescription officials reported that specialty-drug spending fell 12% and confirmed that medication authorizations and patient check-ins remain required for certain costly drugs. The commission asked for a one-page explanation of estimated savings and steps for a proposed prescription copay change.
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