Neosho County commissioners voted 3-0 on Sept. 25 to renew the county's employee health insurance with a Blue Cross Blue Shield Kansas proposal that county staff recommended as the least disruptive option.

The new package — adopted as “Option 1” in a motion to renew medical coverage with Blue Cross, move dental to Blue Cross of Kansas, and move vision to Blue Cross/EyeMed — carries an overall 17.3 percent projected increase when the one-time $62,000 premium holiday is included. The commission approved the motion and second, and the clerk recorded the vote as unanimous, 3-0.

County staff and IMA benefits representatives told the commission the renewal year was unusually difficult because medical claims drove the renewal costs. “The loss ratio finished at a 137%,” Nick Johnson, an account executive at IMA who presented the renewal options, said. That figure means claims exceeded premiums by 37 percent during the plan year, Johnson said.

Why it matters: commissioners said they wanted to avoid reducing employees’ recent pay raises by sharply increasing employee premium contributions. Johnson’s recommended package (Option 1) includes modest plan-design changes — a $50 specialist copay and removal of an accidental-injury benefit — that, together with moving dental and vision to Blue Cross, reduced the county’s overall premium increase compared with the insurer’s initial renewal offer.

Details of the decision: the commission adopted the package described by the IMA representative. Under the adopted illustrations, the county’s net increase for health and dental is roughly $197,000 annually, while employees would collectively pick up about $17,000 (about an 11 percent increase for employee-paid portions under the recommended contribution illustration). IMA’s materials showed alternative contribution scenarios that would shift more of the cost to employees; commissioners said they preferred the option that spread the increase more to the county to protect employees’ net pay.

Discussion: commissioners asked about technical items staff had raised, including whether deductibles across medical, dental and vision could be “accumulated” into one shared deductible if all plans were moved to Blue Cross. Johnson said that consolidation would require a custom benefit design, likely raise rates, and need management approval from the carrier; he said it was unlikely to be approved on short notice.

Budget context: county staff said the adopted renewal fits within the board’s budgeted increases. Finance staff reported health-insurance spending through August was approximately $115,000 under a straight-line budget projection, which, annualized, would be near the additional county cost for the renewal in the presentation. Commissioners discussed social-security (FICA) cost effects from pay increases and asked staff to show the final payroll cost impact once open enrollment concludes.

Next steps and implementation: commissioners directed staff to proceed with an active enrollment process because the county will be moving benefits to Blue Cross; human-resources staff said open enrollment would be the last week of October and that in-person appointments would be scheduled to explain the changes to employees. The county will also adopt the dental and vision moves that triggered the $62,000 one-time premium holiday.

What the motion included: the motion language recorded at the meeting specified renewal of medical with Blue Cross Blue Shield Kansas at the recommended plan design, moving dental to Blue Cross (7.8 percent increase) and moving vision to Blue Cross/EyeMed (2.2 percent increase), and continuing employee-benefit administration through AmeriLife. The motion passed unanimously.