Walworth County Human Resources Committee reviewed proposed updates to the county health plan on June 18, including a required deductible increase tied to HSA rules, an option to allow employees to complete full bloodwork at an Aurora clinic for a lower fee, an MRI reimbursement incentive pilot and proposed formulary changes that could require step therapy for certain biologic drugs.

Josh Pollock, the county’s benefits manager, told the committee the Internal Revenue Service’s 2026 increase to the minimum deductible for high-deductible health plans means the county’s single-plan deductible must rise by $50 and the family deductible by $100 to remain HSA-eligible. “We are required by the IRS to follow those guidelines,” Pollock said. He added the county’s current high-deductible plan is at the IRS minimum and that recent deductible changes in prior years have been limited to the IRS-required amounts.

Public commenter Jennifer Church, a county public-health employee who said she currently carries county insurance as a single subscriber, described difficulties she’s had with HPS — the county’s network administrator — after visiting providers. “When you go in to see the doctor and then you get the medical bill from HPS, it's hard to know…to make sure they're accurate,” Church said. She described being placed on a payment plan that did not automatically roll new charges into the plan and said sudden collections notices followed. Pollock explained HPS’s collections timeline to the committee: notices and call attempts occur over roughly 120 days before accounts are sent to collections; he said payment plans typically can be adjusted to roll new charges into the total but must be requested by the member.

Pollock outlined several benefit changes under consideration. Beginning in 2026, Advocate Aurora could provide full venipuncture blood draws at its clinics for employees during a broader window (January–June), at an estimated $30 per person versus roughly $150 per person for the on-site venipuncture event that the county currently runs. The committee would still offer on-site screening events; the Aurora option would be voluntary. Pollock also proposed reinstating an MRI reimbursement incentive (a $100 reimbursement after use of a lower-cost standalone MRI provider) and adding a smoking-cessation option through Tria Health at $300 per enrolled participant.

On prescription coverage, Pollock described a potential formulary change that would require patients pursuing biologic drugs Humira or Stelara to try up to three biosimilar alternatives first (a step-therapy requirement). He said the plan currently has 11 members on Humira and two on Stelara and that biosimilars could create significant savings if clinically appropriate; members would still have a pathway to brand drugs if biosimilars fail.

Committee members asked for premium figures and specific pricing details; Pollock said premiums are typically presented in July and that the committee would receive phased premium changes if the committee moves to a new four-tier enrollment structure (single, employee + spouse, employee + children, family) in 2026. No final plan changes were adopted at the meeting; Pollock characterized most items as still in the research stage and said any final changes would be presented for committee approval before being implemented.