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Lauderhill approves Cigna renewal; HR, broker and some employees report denials and formulary problems
Summary
The commission approved renewal of the city’s group health plan with Cigna for the remaining four years of a five‑year contract and authorized payment of $9,656,464. City staff and the broker reported a high claims year; employees and Commissioner Dunn cited denied days, prescription formulary problems and out‑of‑pocket costs.
Lauderhill commissioners on Aug. 25 approved a resolution to renew the city's Cigna group health insurance through the remaining four years of a five‑year agreement and authorized payment of $9,656,464. The vote was 4–1; Commissioner Dunn voted no.
Human Resources and the city’s broker reviewed the first year of the Cigna plan. Mike Gowen of Gowen Benefits Group said high claims produced a projected 25% increase, but the negotiated two‑year rate cap limited Cigna’s increase to 10%, a-saving the city roughly $3.4 million compared with the uncapped projection. Gowen said the city had paid roughly $6.7 million in premium and Cigna paid $6.4 million in claims, a loss ratio of about 96%.
HR told the commission about implementation challenges during the transition from Humana (the city’s prior carrier for roughly 30 years). HR said complaints represent less than 10% of covered employees and that many reported issues stem from prescription formularies — some long‑used doctors do not accept Cigna and some previously inexpensive drugs under Humana are higher cost under Cigna.
Commissioner Dunn described her personal experience with claim denials and access: “When I get to the ER, my blood sugar is 531… Cigna denied covering 1 of the days that I was in the hospital,” she said, and described difficulties obtaining prescription coverage and a continuous glucose monitor. HR and the broker said they have intervened on individual cases and are compiling issues to bring to Cigna; staff recommended continued education for employees on plan options and preventive care.
City leaders said they want Cigna to attend a future workshop to address systemic problems and that administration will examine plan options and potential incentives to reduce high‑cost claims. Staff also noted the contract can be revisited, but going to market immediately after one year could affect future negotiations; HR recommended giving the relationship additional time while addressing known problems.
Outcome: Commission approved renewal and the associated payment authorization; staff will pursue follow‑up meetings with Cigna and pursue employee education and claim‑management initiatives.
