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Doña Ana County approves projected 8.7% increase in health insurance funding for FY2026
Summary
After a presentation on plan performance and medical/prescription trends, the board approved an 8.7% funding increase for the county’s self‑funded health insurance plan effective July 1, 2025.
Doña Ana County commissioners voted April 22 to accept budget projections that increase county health-insurance funding by an estimated 8.7% for the fiscal year beginning July 1, 2025.
Human Resources staff introduced the item and Gallagher Benefit Services presented the financial and actuarial analysis. John Hats, area vice president at Gallagher (benefits consultant), told the commission the county’s self-funded plan ran at roughly a 97% loss ratio through December 2024 and that medical and prescription-drug trend assumptions (roughly 7% for medical and about 11% for pharmacy) drove the recommended 8.7% increase in funding.
The presenters said prescription drugs account for about 22% of total claims and that a small number of high-cost claimants account for a large share of total expenditures. The plan currently purchases stop-loss insurance and the county maintains reserves to manage volatility; commissioners were told the combination of reserves and stop-loss protection mitigates catastrophic cash-flow risk.
No major benefit design changes were proposed. The only plan design adjustment mentioned was an IRS-required increase to the high-deductible health plan deductible (from $1,600 to $1,650) to maintain its qualified status for a health savings account. Human Resources said open enrollment for plan changes would be scheduled in late May and run into early June, with new rates effective July 1.
County staff provided an estimate of employee premium impacts on a biweekly basis: for example, employees in the main PPO plan in single coverage would see an increase of about $8.10 per pay period; family coverage increases were larger. Commissioners asked about stop-loss coverage and reserve protections; Gallagher and HR confirmed stop-loss limits and county reserves are in place to limit exposure.
The commission approved the FY2026 funding projection by roll call as presented. The action sets the budget baseline for benefits funding in the upcoming fiscal year and directs HR to proceed with employee open enrollment under the adopted assumptions.
