LaSalle County insurance plan running above expectations as large claims and specialty drugs drive volatility

The Horton Group told the LaSalle County Insurance Committee that the county’s self-insured health plan is running above the underwriter’s expectation through August, at 108.6% of projected cost and a per-capita spend of about $25,005.33 compared with an expected $23,005.00.

The difference is driven largely by a small number of very large claims and increased pharmacy costs, Horton Group representative Beth said. “We still have a quarter left, so with the next four months we could see this taper off if there aren’t any new situations because your plan does have protection on large claims over a $150,000 stop‑loss deductible,” Beth said.

Why it matters: committee members must weigh higher renewal pricing and stop‑loss terms against plan design and enrollee impacts ahead of the full‑board renewal decision. Horton Group said carriers and actuaries are still adjusting to new clinical and pharmaceutical risks,…