Warren County Board of Commissioners staff presented recommended changes to employee health plan funding and related benefits for 2026, including a proposed 10% increase to total funding rates, a recommendation to change stop‑loss carriers to reduce fixed premium costs, and proposals to ease access to weight‑loss medications and pilot a lifestyle spending account.

The recommendation presented would raise the county’s and employees’ combined funding rates by 10% for 2026. Under the scenario shown to commissioners, employees would continue to pay 15% of premiums for the buy‑up plan and 0% for the base plan; staff also presented alternate scenarios that keep a 15% employee cost share or that reduce the buy‑up share to 10% in future years if trends allow. Staff said open enrollment is scheduled for the first week of November and indicated timelines require a decision by the commissioners or final staff direction to prepare materials.

County benefits staff emphasized that the plan remains comparatively “rich” versus private‑sector and some public benchmarks, particularly the 0% employee share on the base plan, and recommended continued monitoring of pharmacy and medical trends before making more durable design changes. Staff reported that four members have been accepted into an internal Samaritan Fund that can assist employees with high out‑of‑pocket costs and cautioned that relying on that fund to control premiums presents long‑term risk.

On stop‑loss insurance, staff said the incumbent carrier, HCC, submitted a renewal that would increase the fixed stop‑loss premium by 25%, raising annual premium from about $590,000 to approximately $737,000. Market quotes produced one competitive alternative from a national stop‑loss carrier presented to the board (listed in the materials as “1 80”), which offered a firm renewal at about a 6.4% increase and an annual premium near $627,000–$628,000 — roughly $110,000 less than the HCC renewal. Staff noted both carriers did not propose individual “laser” provisions on new business; staff also said HCC’s renewal would require raising the aggregating specific (an aggregate deductible) from $500,000 to $625,000. After discussion, staff recommended selecting the market alternative under the option‑1 structure described in the presentation.

Staff also reviewed pharmacy benefit management. They compared the county’s current PBM discounts under AeroRx/EVO to a newer coalition PBM option (NACo Rx) and reported that current contract discounts—especially on brand drugs—were stronger under the county’s existing arrangement. Staff said NACo Rx is expected to strengthen over time as more counties join the coalition and that rebate guarantees and back‑end settlements vary across vendors and can affect net cost.

On weight‑loss medications, staff proposed reducing access thresholds to improve member experience and adherence while seeking to limit uncontrolled utilization. Current coverage requires a body‑mass index (BMI) greater than 30. The proposal would allow members with a BMI of 25 plus a qualifying comorbidity to access therapy, and would permit members without comorbidities to access therapy at BMI 28. Staff also proposed easing or removing an annual re‑verification requirement so that members who respond to therapy and lower their BMI would not immediately lose access to maintenance medication. Staff said compliance questions remain and that mid‑year adjustments could be proposed if necessary.

Separately, staff discussed exploring a county‑funded lifestyle spending account designed to help recruit and retain a younger workforce. The proposed account would be funded by the county (for example, a matched or flat contribution such as $250–$500 per employee was discussed as illustrative, though amounts were not final) and could be used for items such as gym memberships or childcare services; the account would use post‑tax dollars and sit alongside, not replace, existing pretax dependent‑care FSAs. Staff described several possible eligibility tiers based on tenure and said further design work and compliance review would be needed before the board would be asked to adopt any program.

Commissioners and staff discussed trade‑offs among benefit generosity, recruitment, administrative complexity and long‑term sustainability. Several commissioners urged continued monitoring of pharmacy and medical trends before making permanent design changes; at least one commissioner expressed concern about relying on the Samaritan Fund and a small number of high‑need families to keep premiums manageable.

No formal vote or board action on the funding increase, stop‑loss recommendation or the lifestyle account appears in the provided transcript. The meeting record shows staff concluding the presentation and the board later moving to adjourn.