Rutherford County’s insurance and purchasing committees presented recommendations May 8 to the Budget, Finance and Investment Committee that would raise active and pre-Medicare medical premiums by about 6% for 2026 while keeping dental and vision premiums unchanged.

Ed Elam, the county’s insurance and risk management director, told the committee the recommendation came from the insurance committee and purchasing after actuarial analysis and competitive review. “The recommendation coming from the insurance committee and, forwarded to the budget committee was a 6% increase for active and and pre Medicare medical plan rates,” Elam said.

Nut graf — why it matters: The county is self-insured for medical coverage with a stop-loss policy. Changes to premiums, deductibles and benefit design affect county budget planning and employees’ out-of-pocket costs. The committee also considered the retiree Medicare Advantage plan and ancillary benefits packages that shift some costs or options to employees.

Key details:
- Stop-loss and plan funding: Staff said the county is fully self-insured with a stop-loss attachment at $500,000 per covered employee. Premiums are paid into the county’s self-insurance fund and set using an annual actuarial analysis intended to smooth rate volatility.
- High-deductible plan: In keeping with IRS guidelines, the 2026 embedded high-deductible health plan employee-only deductible will increase by $100.
- Dental and vision: No increase in premium rates for 2026 was recommended.
- Medicare Advantage (retiree) RFP: Purchasing opened the RFP for a retiree Medicare Advantage option; the committee recommended Humana Option 3 at $220.28 per member per month, down from the 2025 premium of $261 per member per month — an approximate 15% premium savings to the county’s retiree plan participants.

Votes and next steps: Committee members moved and voted to accept the insurance committee’s recommendation on the 2026 active employee health, dental and vision plan rates and separately approved the Humana Medicare Advantage option after standard roll-call procedures. Staff said some items had to be voted on separately for audit reasons.

What staff said about competitiveness and rate setting: Commissioners asked whether premiums are competitive with state plans. Elam and other staff explained rates are set using internal actuarial analysis and that the county monitors the state plan rates; the state’s official rates for 2026 had not yet been released. The county attempts to meet or exceed the state plan on several tiers but budgets conservatively to protect the self-insurance fund.

No changes were made at the meeting to Medicare Advantage benefits beyond selecting the lower-cost Humana Option 3; details about retiree cost-sharing and effective dates will follow contracting and purchasing processes.