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County staff recommends renewing medical benefits with Cigna; John Leggett says plan running below budget
Summary
Benefits consultant John Leggett reported the county’s self-funded plan is running better than budgeted and recommended staying with Cigna for medical administration; staff proposed lowering out-of-pocket maximums and discussed optional coverage of GLP weight-loss medications with conditions for medical necessity.
John Leggett of MSI Benefits Group briefed commissioners on May 5 about the county’s employee health, vision and dental programs ahead of the FY26 renewal. Leggett recommended keeping Cigna as the medical administrator and reported that claim experience year-to-date was running well below the budgeted amount.
Leggett said the county’s annualized claims experience through February projected about $6.2 million in total claims against a budgeted gross cost of roughly $7.8 million. He told the board that lower pharmacy costs under the county’s Veracity pharmacy carve‑out and active rebate programs also helped performance.
Leggett summarized staff recommendations: remain with Cigna as administrator, accept modest increases in dental and vision premiums, and consider lowering members’ maximum out-of-pocket amounts. On that last point staff proposed reducing the individual/family out-of-pocket maximums and asked the board whether the county should instead preload a health-savings/HRA-style fund for catastrophic cases.
Commissioners pressed for clearer employee-facing explanations of deductibles and coinsurance; one commissioner described fluctuating bills from late-2023 and asked for simpler member communications. Leggett and staff said the county can consider an internal HRA or lowering the out-of-pocket maximum but noted each option affects expected claim liability and budget assumptions.
Leggett also discussed specialty and GLP (weight-loss) medications. He said some specialty drugs are already covered with member costs reduced via manufacturer assistance programs; Veracity recommended that if the county elects to cover GLP medications the employee copay would likely be around $300 (approximately $200 after manufacturer assistance in many cases). Staff noted a policy distinction: coverage for GLP meds prescribed for clinical comorbidities may be treated differently than coverage for elective weight-loss use.
No formal vote was recorded at the workshop; staff recommended the Cigna option and said dollar projections aligning with the county’s adopted FY26 budget will be provided for final approval.
Ending: staff will return with final renewal paperwork and plan-design choices for the board to adopt during the budget process.
