North Platte council renews stop‑loss contract after discussion on IVF coverage

The North Platte City Council on March 18 voted to renew the city's stop‑loss reinsurance contract for its self‑insured health plan and discussed whether the plan should add coverage for in‑vitro fertilization and related treatments.

The discussion focused on whether a proposed $15,000 lifetime benefit for IVF and NaPro (naturally procreative) technology could be added without increasing the city's cost if the stop‑loss reinsurer refuses to reimburse that benefit. Tanner Paterra, co‑broker with Hub International, told the council that the city can include such language in its plan document, but the stop‑loss carrier has the option to exclude coverage it deems experimental or not standard and would then not reimburse those claims.

That distinction matters because stop‑loss reinsurance reimburses catastrophic or above‑threshold claims to limit employer exposure. "If you add something that is outside the norm of what is considered standard health coverage, the stop‑loss reinsurance policy can choose not to cover that," Paterra said. He added that the city could amend plan language but could not guarantee reinsurance coverage without the reinsurer's prior approval.

Councilmembers asked how amendments would affect reimbursement mechanics. Paterra and city staff explained that if the stop‑loss carrier declines to treat an IVF benefit as a covered loss, the city would be responsible for the cost and employees would not be reimbursed under the stop‑loss specific deductible. A sample specific deductible figure was discussed in general terms (the broker referenced a hypothetical specific deductible of about $100,000), but the council did not set or change that amount during the meeting.

After the discussion, Councilmember Reeker moved and a colleague seconded a motion to approve the consent agenda item authorizing the mayor to sign the health and accident contracts renewing the stop‑loss coverage effective April 1, 2025. The motion passed.

The council and staff agreed there is still time to amend the plan document after renewal to add or refine language and that the city should seek reinsurer review of any new IVF or similar benefit before finalizing plan changes.

The city will proceed with the renewed stop‑loss contract; any future change to include IVF or other fertility‑related benefits will require staff to confirm whether the stop‑loss carrier will accept the amended language or whether the city will absorb uncovered claims.