The LaSalle County Insurance Committee voted to forward a recommendation to switch the retiree Medicare Advantage carve‑out to Humana for medical coverage and Express Scripts (ESI) for pharmacy claims while keeping Benistar as the retiree administrator, and to forward the resolution and rate exhibits to the full board.

Thornton Group presenters told the committee that retiree pricing under the current Blue Cross arrangement jumped sharply. The presenter said last year the combined medical and prescription premium was about $402.40 and that the same plan design this year would cost about $603 (figures provided by the benefits consultant as a comparison of prior and current quotes). The consultant said the Medicare Advantage market’s reimbursement changes and new prescription caps are part of the driver and that Benistar has historically administered the county’s retiree program.

After a line‑by‑line comparison of benefits and pharmacy design, Thornton Group said Humana and Express Scripts provided similar or in some cases enhanced benefits and would preserve access to providers because Medicare is the primary network for these participants. The consultant explained, "the network is Medicare. So if the provider accepts Medicare reimbursements and rep Medicare payments, they're in the network." The presentation noted that Humana is a major Medicare Advantage carrier in the market and that Express Scripts is one of the largest PBMs with broad pharmacy coverage; the presenter said this arrangement would reduce volatility compared with the quoted Blue Cross renewal.

Committee members asked about provider disruption that occurred with previous Medicare Advantage switches, specifically naming Morris Hospital. Thornton Group said Morris Hospital accepts Medicare reimbursement and that the contract structure for the carve‑out includes an open/passive access arrangement for providers; presenters said they did not expect the switch to create provider access problems for retirees who accept Medicare.

Formal action: the committee moved, seconded and approved forwarding the Humana/Express Scripts recommendation and associated resolution to the full board. Roll call votes recorded were James Bailey — yes; Craig Emmett — yes; Doug Stackley — yes; Tom Walsh — yes; Nancy York — yes.

The committee asked Thornton Group to provide the rate exhibits and communications materials the consultants will use for retiree outreach; the final resolution and attachments will be presented for signatures at the full board meeting.