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County health insurance fund running $3.1M deficit; benefits consultant urges continued plan changes
Summary
Benefits consultant Carrie told the finance committee the county’s self-insured health plans show a year-to-date deficit of roughly $3.1 million through April and outlined plan design changes and member engagement as mitigation measures
Carrie, a benefits consultant to the county, told the Davidson County finance committee the county’s employee health plans are running a year-to-date deficit of about $3.1 million through April and recommended continuing modest deductible increases and member engagement to reduce costs.
“Premium is paid on the left, claims paid on the right,” Carrie told the committee while reviewing a packet distributed before the meeting; the packet showed a deficit “about $3,100,000, almost 3.2.” She said the county’s plan designs include a $1,000 PPO, a $2,500 PPO and two HSA plans, and that average membership is about 425 lives.
Carrie recommended continuing to shift toward higher deductibles and using member-facing tools — telemedicine, pricing apps and wellness screenings — to reduce use of higher-cost services. She cautioned the committee that two major drivers of near-term cost increases are newer weight-loss drugs (discussed in the meeting as “GLP-1s”) and other high-cost specialty pharmaceuticals.
On property/casualty insurance, Carrie summarized loss-control activity by the county’s carrier and said the carrier’s representative, Mark Bell, and team performed about 43 visits to county facilities in the prior 6–7 months; those visits included the sheriff’s department, facilities maintenance and the nursing home. County staff said a recent property walk-through identified one or two county assets omitted from the schedule and that adjustments would have minimal fiscal impact.
Committee members asked how the county’s experience compared with other groups; Carrie said Davidson County’s trends were “pretty average” for fully insured groups but cautioned that population age and chronic conditions materially affect loss ratios and claims trends.
The committee did not take a formal vote on benefit design changes at the meeting; Carrie said she would provide any follow-up data if requested and that the county has been gradually increasing employee deductibles over several years.
Committee members asked questions about the potential insurance impact of a sale of the county nursing home; Carrie said removing the nursing center from county ownership would “cut your insurance premiums by a lot,” though she did not present a formal estimate at the meeting and said she would follow up with more precise figures if requested.
The finance committee also received a report that the county’s wellness screening program had recently run screenings and that the benefit team recommends continuing such programs to increase engagement.
