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County reports lower medical claims but higher prescription costs; stop‑loss renegotiation cuts exposure
Summary
Benefits staff reported to the Oklahoma County Board of County Commissioners on June 17, 2025, that year‑to‑date medical claims are down about $34,000 from the previous year while prescription claims are roughly $1 million higher, and they described contract renewals that reduce stop‑loss exposure.
Benefits staff reported to the Oklahoma County Board of County Commissioners on June 17, 2025, that year‑to‑date medical claims are down compared with the same point last fiscal year while prescription claims are higher, and they outlined several contract renewals for the coming year.
The update matters because the county’s self‑insured plan costs and vendor contracts affect both county finances and employee benefits. Benefits staff said medical claims were about $34,000 lower than at the same point last fiscal year, a positive trend. By contrast, prescription claims were roughly $1 million higher; staff explained that the apparent increase is largely because an extra month of prescription claims from the prior fiscal year had been paid during the current reporting period. Netting reimbursements and rebates, staff said overall medical and prescription costs were up about 3% year‑to‑date compared with a budgeted 5%.
Benefits staff reported stop‑loss reimbursements year to date of about $14,000 and said final stop‑loss activity would be known when the last check register for the fiscal year was processed. They also said prescription‑drug rebates significantly exceeded budget projections by more than $1 million.
On renewals and contract pricing, staff said the third‑party administrator UMR had an administrative‑fee increase of about $10,000 annually while the stop‑loss component negotiated a $190,000 reduction for the next fiscal year, reflecting a low stop‑loss claim year. Benefits staff said, “on the admin fees, those are going up about 10,000 a year, but I've negotiated with stop loss to reduce stop loss by 190,000 on this next fiscal year since we had such a low claim year in stop loss.” Commissioners approved the UMR renewal by motion and voice vote.
Staff also reported on retiree coverage and other vendor renewals: two years ago group Medicare Advantage costs were about $3.6 million; staff said the county paid $1.6 million this year through Blue Cross Blue Shield and that the Blue Cross renewal would increase to $1.8 million next year (an increase of roughly $200,000). The county’s surgery center agreement, vision plan and YMCA membership program were presented as cost‑saving or unchanged arrangements; commissioners approved those renewals by motion.
Benefits staff noted the county’s employer health clinic charges follow Medicare‑based fee schedules and that clinic fees rose about 5% and operate at approximately 140% of Medicare rates, still lower than typical network providers. The commission approved those renewals and related items by motion and voice vote.
No further action beyond approving the listed renewals was taken at the meeting; staff said final accounting for stop‑loss reimbursements would be available when the fiscal‑year check register was completed.
