Toledo City Council approves $1.3M stop loss insurance contract with Anthem

The Toledo City Council meeting on April 29, 2025, focused on critical discussions regarding the city's health insurance program and technology upgrades.

A significant topic was the annual request for a contract for stop-loss insurance, which protects the city against high healthcare claims. The current contract with Anthem Blue Cross and Blue Shield is set to expire on May 31, 2025. After a bidding process that took place from February to April, the city received three proposals. The council is recommending a one-year contract with Anthem, starting June 1, 2025, at an estimated cost of $1.3 million. This figure represents a notable increase from last year's premium of approximately $795,000, attributed to a rise in catastrophic claims experienced by the city.

City officials explained that the stop-loss insurance activates when claims exceed $600,000, providing financial protection for the city as it is self-insured. The decision to continue with Anthem was influenced by their role as the city's third-party administrator, which simplifies the claims process. The other bids were not competitive enough, potentially costing the city significantly more in the long run.

Council members expressed concerns about the rising trend of catastrophic claims, particularly in pediatric and cancer cases, which are becoming more common nationwide. The increase in claims is linked to advancements in medical technology and treatment options, which, while beneficial, come with high costs.

In addition to the insurance discussion, the council also addressed a proposal from the Department of Information and Communication Technology (ICT) for the purchase of replacement PCs. This initiative, costing up to $250,000, aims to upgrade the city’s technology infrastructure and transition from Windows 10 to Windows 11, ensuring continued security and functionality.

The meeting underscored the city's proactive approach to managing healthcare costs and technological advancements, reflecting broader trends in public health and IT management. The council's decisions will have significant implications for the city's budget and operational efficiency in the coming year.