County approves 2026 benefits changes and wellness program; staff to return with PBM and ancillary provider recommendations

The Seminole County Board of County Commissioners voted unanimously to authorize staff recommendations on benefit plan design, employee premium contributions for plan year 2026 and continued wellness programming after a presentation from Human Resources and benefits consultant Alliance. Christina Brandolini, Seminole County's human resources director, and Charles Cook of Alliance presented enrollment, claims and vendor analyses. Cook said the county has seen relative stability in claims per employee over recent years but noted a spike in major case claims in 2024 and continued elevated cancer diagnoses carried into 2025. He called the county a "poster child" for wellness programming that includes mandatory annual physicals and described July claims that month as lower than the prior 12-month average. Brandolini and Cook recommended a set of market-alignment changes to minor co-pays and plan design while preserving the deductible levels. They proposed moving toward a "core buy-up" approach that sets a consistent employer-funded base contribution across tiers and lets employees buy up to richer plans. The county’s recommended change would keep employer funding for the base $1,000 deductible plan across enrollment tiers while requiring employees who choose the $500 or $250 deductible plans to pay the difference. For the HSA option the county proposed increasing the employer HSA contribution from $500 for employee-only coverage to $500 for employee and $1,000 for family coverage. The board also reviewed the county’s PBM and specialty vendor work. Alliance ran a PBM (pharmacy benefit manager) procurement that returned two finalists; Cook recommended staying with Cigna’s integrated PBM for now because the estimated savings gap to the finalist Navitas did not justify a disruptive vendor change. On prescription-care-management (PCM) support (clinical outreach to change high-cost meds), staff recommended continuing with the incumbent because the vendor’s physician-first outreach process is a differentiator and because projected savings were stronger than other finalists. On voluntary and ancillary coverages Alliance recommended new carriers or vendor consolidations for dental, specified disease and other voluntary programs; results and scorecards were provided to the board and staff will return with final recommendations at the Aug. 26 meeting. The board’s vote: a commissioner made a motion to "do all of the actions that are up on the screen," and another commissioner seconded. The board voted "aye" with no recorded opposition; the motion carried unanimously. Why it matters: The action sets the county’s benefit structure and the wellness program for 2026, affects payroll deductions and employer contribution levels, and authorizes staff to finalize pharmacy and ancillary vendor contracts in time for next year’s open enrollment. Commissioners repeatedly emphasized employee education — including reaching spouses or household decisionmakers — as essential so workers understand plan differences, HSA mechanics and wellness incentives. Next steps: Staff will implement the minor plan-design updates and the Thrive-for-5 wellness program, provide a higher-resolution fare of PBM options and bring recommended vendors for ancillary benefits to the Aug. 26 board meeting for formal approval. Brandolini said staff will continue communications and is considering multiple formats (live sessions, video, incentives) to raise enrollment-education participation.