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Council renews self‑funded employee health plan with modest premium increase; Medicare Advantage carrier change announced
Summary
The Town Council approved renewal of the town’s self‑funded employee group health program with a 2.3% premium increase and a carrier change for retirees; consultants from Horton Group presented financial context and noted rising large‑claim and pharmacy costs.
The Town Council on Oct. 6 approved renewal of the town’s employee group health insurance program after staff and consultants described the fund’s financial position and recommended continuation of current plan features with a modest premium increase.
City Manager Reese told council that the town’s health fund is self‑funded and “in a strong financial position.” Horton Group representatives Mike Wojcak and Beth Ishmael summarized recent trends: the town’s move to the UMR third‑party administrator, demographic shifts toward a younger workforce, and improvements from pharmacy contracting. Horton Group cautioned that large, complex claims and new high‑cost therapies remain an ongoing risk for all plans.
Staff said the requested premium increase for this year is 2.3 percent. The increase is borne by the employer for single coverage; premiums for coverage that includes dependents are shared between employer and employee as usual. Staff also said the town is making a small carrier change for the retiree plan; staff and consultants characterized that as administrative and said it would not change day‑to‑day benefits for retirees.
Council members asked about network adequacy and Medicare Advantage network changes. Horton Group staff explained that the town’s retiree arrangement is pooled through a broker and that providers who accept Medicare reimbursement are considered in‑network for the plan. Council approved the renewal by roll call.
