DuBois County adopts new 2026 health plan changes, raises non-wellness cost-sharing

DuBois County commissioners voted Aug. 4 to adopt a revised benefits package for 2026 that raises out-of-pocket exposure and monthly premiums for employees who do not participate in the county's wellness program while keeping lower rates for employees who do.

Supporters said the change balances benefits for employees with the county's need to control rapidly rising healthcare costs. A staff presentation cited national cost trends — including a multi-year rise in medical and hospital costs — and local claims experience.

The approved package (presented at the meeting as the staff's compromise, "proposal 3") keeps the wellness tiers at lower premiums but increases the non-wellness premiums and deductibles. Commissioners approved the proposals by motion; both the pharmacy design changes and the medical-plan design changes carried on voice votes.

Why this matters: County staff said health benefits are one of the county's largest expenses. The presentation showed the plan's average per-employee monthly cost rose to about $1,968.77 for the six-month period cited, and staff projected the county could face roughly $5 million in total health-care spending if trends continue. Commissioners said they wanted to preserve broad coverage while requiring more "skin in the game" from non-participating employees.

Key items approved (numbers as presented to the board): wellness monthly premiums kept at a low tier for participating employees (presented as approximately $40 for single coverage and $90 for employee-plus-spouse/children, family at $125); non-wellness monthly premiums set higher (presented approximately $61 single, $115 employee-plus-spouse/children, $160 family); wellness deductibles presented as $750 individual/$1,250 family; non-wellness deductibles $1,500 individual/$2,500 family; wellness out-of-pocket limits presented at about $1,350 individual/$3,500 family; non-wellness out-of-pocket limits presented at about $2,500 individual/$5,000 family. Commissioners explicitly directed staff to carry the approved figures into the 2026 enrollment materials.

Pharmacy changes: The board also approved the staff's middle-path pharmacy proposal (adopted as "proposal 3"), which keeps tiered copays for generic and preferred drugs but raises copays on higher-cost brand and specialty tiers and increases the prescription deductible to the level presented in the compromise package. Staff emphasized programs the county will use to limit specialty-drug spend (for example, manufacturer-patient-assistance routing and an Rx-procurement program staff described as RxProtect, which aims to obtain selected specialty medications at reduced or no cost to the plan). The pharmacy proposal passed on a motion and voice vote.

What the board did not do: Commissioners stopped short of removing specialty drugs from coverage altogether, saying that step would produce an immediate large saving at the cost of potentially severe hardship for a small number of employees who rely on those therapies.

Next steps and questions: Staff will publish the finalized plan documents and premium tables for open enrollment and prepare employee communications that explain how to qualify for the wellness tier (annual biometric screening or physician documentation). Commissioners asked staff to continue negotiating with Deaconess on a proposed on-site clinic model and to return with cost estimates and a timetable for implementation.

Speakers quoted or listed in the meeting transcript were staff members presenting benefits options and county commissioners; quotes in the article are taken from the staff presentation and the record of the Aug. 4 meeting.

Ending note: The changes are effective for plan year 2026; staff will publish formal enrollment instructions to employees before open enrollment in November.