Lee County insurance committee reports 13.5% health-rate increase; committee recommends keeping GLP‑1 coverage

Lee County insurance officials told the Board of Commissioners that the county's medical insurance rates will rise about 13.5% for the next plan year, and the committee recommended retaining current coverage rather than removing GLP‑1 (weight‑loss) drugs. The recommendation came after an insurance committee meeting in which the county's benefit consultant reviewed data showing higher claims and increased use of GLP‑1 drugs, which the committee said contributes to the premium rise alongside several large, one‑time claims. The committee advised the board to incorporate the higher rates into next year's budget rather than make immediate coverage changes. Why it matters: a 13.5% jump in medical rates will increase county expenditures and affect the budget the board will adopt for FY 2026. Board members were told employees currently pay 25% of premiums and the county 75%; unless that ratio is changed, the county's share of expenses will rise. At the meeting, the committee presented four rate options. Option 1 was to keep current coverage and accept the increase. Option 2 would remove GLP‑1 drug coverage and produce an estimated 3.5% rate reduction. Two other options would make coverage requirement changes and yield estimated 1% and 0.5% reductions. Committee members said the smaller savings did not justify administrative complexity or coverage gaps for employees. The deadline to remove GLP‑1 coverage (Option 2) was reported as July 31; other plan-change options have a September 12 deadline. Committee members said the county's claims were roughly $3.5 million higher than the prior year and that enrollment grew about 3.2% with an average covered age of 33.2 years. The consultant reported about 18 employees were using GLP‑1 drugs in the plan data reviewed and that the consultant values the drug at roughly $1,250 per dose. Committee members also noted that many other pool members are seeing similar trends. The county participates in a multi‑employer insurance pool, with Blue Cross Blue Shield administering the excess layer. Committee members said a standalone commercial policy considered in past procurements was materially more expensive than remaining in the pool, and that the pool has produced savings over time. The committee recommended deferring a market search until a full procurement process can be run next year and asked that the projected rate increases be reflected in the county's upcoming budget discussions. Next steps: the committee's recommendation is to accept current coverage and include the 13.5% medical and a 9.5% dental increase in the FY 2026 budget. The insurance committee plans to revisit broader market review in 2026 and to present any formal proposals to the full board before changes are implemented.