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NACO benefits manager presents self‑funding and enrollment options to commissioners; county to consider review ahead of July renewal
Summary
NACO officials pitched a pooled self‑funding option, an enrollment system and related benefit services; commissioners asked staff to collect plan data for a comparative review in advance of the county’s July renewal period.
KEITH COUNTY — Mike Bowden, benefit services manager for Nebraska Association of County Officials (NACO), and a local NACO representative met with the Keith County Board of Commissioners on Jan. 15 to outline insurance and employee benefit options, including a NACO self‑funding offering, a digital benefits‑enrollment system, and other bundleable products.
Bowden said NACO historically operated a fully insured pool but in recent years added a self‑funded option that pairs a Blue Cross network with pooled stop‑loss purchasing to lower unit costs for participating counties. He said one of the pool’s selling points is a lower administrative fee in some packaged plans (Bowden cited an example $6 administrative fee for one Blue Cross package versus typical broker admin fees in the high teens to mid‑30s), noting that a $6 admin fee model is supported by pharmacy‑rebate sharing and aggregate purchasing.
Bowden also described an enrollment and member‑data management tool that streamlines onboarding, cleans addresses and dependent records, and supports on‑site enrollers who can sit down with staff and employees. He recommended starting an evaluation in April to be ready for a July renewal cycle if the county wants to pursue proposals. Bowden said self‑funded stop‑loss options can be negotiated with carve‑outs (no lasers) and that the NACO program partners with specific carriers and financial arrangements that leverage membership scale.
Commissioners and staff asked about network access (for example, CHI/CHI‑owned clinics and the county’s experience with Aetna networks), pharmacy rebates, and student‑loan assistance programs NACO can provide as an employee benefit. Bowden described a new service his office can make available: assistance to employees in applying for and documenting eligibility for federal Public Service Loan Forgiveness and other forgiveness programs; he said the contractor will help employees file paperwork and monitor applications.
No formal action was taken. County staff and commissioners expressed interest in receiving a written proposal and spreadsheets that compare current costs and the pooled/self‑funded options; Bowden suggested the county start data gathering in April so a July renewal decision can be considered without data gaps.
Why it matters: Health insurance is a major county expense. Exploring pooled or self‑funded options can lower per‑member unit cost and change stop‑loss/claim dynamics. Improved enrollment systems can reduce administrative workload and improve employee satisfaction.
Ending: Commissioners asked staff to gather claims and plan documents for a comparative review and to schedule NACO to return with a formal proposal ahead of the county’s July renewal timeline.
