LaSalle County insurance committee hears warning on rising health costs; health-navigation app activation targeted

LaSalle County Insurance Committee members heard an update on the county employee health plan that flagged early-2025 large claims and rising pharmacy costs as the main drivers pushing plan spending above last year’s levels. Beth, a consultant with the Horton Group, presented the quarterly review and discussed pharmacy trends, digital navigation tool performance and next steps to improve member use of available resources.

The committee was told the insurance market remains volatile. "They're struggling to appropriately price the risk that's in the market," Beth said, citing nationwide carrier losses and volatile specialty-drug spending. She said some carriers initially quoted renewal increases in the 20%–30% range for fully insured groups this year, with expectations at the end of negotiations to land in the early- to mid-teens.

Why it matters: large, one-off medical and specialty pharmacy claims concentrate risk in a partially self-insured plan and can significantly raise employer outlays before reinsurance begins. Those dynamics influence the county’s renewal outlook and budgeting for benefits.

Key findings from the presentation

- Large claims and year-to-date spending: The plan ran “hot” in January but normalized across the first quarter. Beth reported four claims above $75,000 in the first three months of 2025, versus two in the same period of 2024.…