DuPage County board adopts a package of health-plan cost controls, phases out certain weight‑loss drug coverage

At a DuPage County Board meeting, Marsh McLennan warned that claims growth — especially from GLP‑1 weight‑management drugs — is driving a sharp rise in the county’s employee health costs, and the board approved a package of plan changes and vendor moves intended to reduce next year’s projected increase. Chris Boucher, employee benefits adviser at Marsh McLennan, told the board the county’s employer net cost could rise from roughly $30.3 million to about $35.0 million in 2026 — a $4.7 million increase, or 15.3% — if no changes are made.

Boucher said much of the 2025 deterioration is tied to prescription drug usage. "The number of unique users [of weight‑management GLP‑1s] has increased," he said, noting 258 users through June 2025, and added, "The numbers are growing exponentially. This is not sustainable." He presented alternatives aimed at slowing cost growth and said a package of changes the board approved would reduce the projected employer increase to "a little over $2,000,000" or about 6.7%.

The board’s decisions targeted multiple parts of the plan. The board voted to: raise the PPO stop‑loss specific deductible from $125,000 to $175,000 for 2026; move the county’s life insurance contract to Dearborn Life after a competitive solicitation; introduce a modest HMO deductible ($250 single/$500 family), add a 10% coinsurance and increase out‑of‑pocket maximums (proposed $2,500 single/$5,000 family), which Marsh McLennan estimated would avoid about $610,000 in employer cost; increase tiered prescription copays (tier‑2 to $45, tier‑3 to $85), estimated to avoid about $84,000; adopt a specialty cost‑share construct (two additional tiers) with a 20% coinsurance up to $200 per fill (a proposal that drew divided votes and was later removed from the table for future consideration); align PPO drug coverage to the HMO "performance formulary" in order to remove higher‑cost drugs (estimated $44,000 in savings); increase employee contributions for medical coverage by 5% (estimated $354,000 of employer relief); and increase employee dental contributions by 10% (estimated $103,000).

On the most contentious proposal — coverage of GLP‑1 medications when prescribed for weight management — Marsh McLennan presented numbers showing county spend on those drugs rising from about $534,000 in 2023 to nearly $1.5 million in 2024, with 2025 already approaching last year’s total by midyear. Boucher presented three timing options: immediate elimination, a July 1, 2026 effective date (which would cut savings roughly in half), or an intermediate phaseout. The board adopted a phased elimination with an effective date in March 2026, after a hand vote and discussion intended to give employees notification time. Boucher said eliminating GLP‑1 coverage for weight management would save roughly $2 million on an annual basis if removed immediately.

Several board members urged caution. Member Covert said she favored removing GLP‑1 coverage for weight management to reduce aggregate county expense but recommended a shorter transition; Member Desart said the drugs are often used for medical reasons and urged the board to weigh long‑term health benefits against near‑term savings, saying "In many cases, it's health driven." Member Galassi recommended a March effective date to limit potential hoarding and to give people time to find alternatives.

Board members also asked about administrative details. Boucher said the county’s plan already uses a prior‑authorization process for GLP‑1s and that Blue Cross Blue Shield of Illinois could not administer a unique, stand‑alone cost‑share only for GLP‑1 weight‑management fills. He described stop‑loss options and said Blue Cross allowed moving specific deductible limits only two levels up in the current renewal window (from $125,000 to either $150,000 or $175,000).

During the public board discussion the group approved the package of plan changes described above by hand or roll‑call votes, with some items receiving divided support and one proposal (the more complex specialty tier coinsurance alternative) pulled from the table after a tie and deferred for future review. Board members said human resources would provide member education explaining which conditions would still qualify for GLP‑1 coverage (for diabetes and other authorized medical indications) and how the plan options differ.

The board’s finance staff said the adopted changes and anticipated savings were incorporated in the 2026 budget presentation, and Finance staff indicated the county’s tort/enterprise fund splits mean the budgeted impact is distributed across funds rather than borne solely by the general fund. The board directed staff to implement the vendor changes and plan design updates and to work with HR on employee communications about the changes and timelines.

The board’s action affects all active plan participants across four county medical plan options, multiple prescription tiers, and employer and employee contribution schedules; officials said further changes could be revisited in next year’s renewal cycle if cost pressures continue.