Caswell County told NCHIP renewal will be 6% next year; commissioners to decide Feb. 17

Dave Costa, a Gallagher representative working with the North Carolina Health Insurance Pool (NCHIP), presented the pool’s history and Caswell County’s renewal profile. He said Caswell joined NCHIP on July 1, 2019, and that NCHIP is proposing a 6% premium increase for the county for the next fiscal year.

Costa explained why the increase is proposed: the county’s reserve balance has fallen to near flat after several high‑cost claims across the pool, and NCHIP seeks to rebuild a target reserve (Caswell’s reserve target was described as approximately $200,000–$250,000). Costa said the pool’s governance caps any single year increase at 6% and that the pool’s long‑term average increase has been about 2.4% compared with industry averages closer to 7–8%.

Costa gave cost context for Caswell: a 6% renewal would increase total funding from roughly $2.4 million to about $2.54 million — an additional roughly $142,000 annually if fully absorbed by the county. He said the pool covers about 10,200 employees and dependents across 29 member governments and that NCHIP’s reserves across all members are about $27 million.

Board members asked operational and risk questions. Commissioners asked whether Caswell could be forced out of the pool; Costa said no current member has been expelled and that re‑admission would require the trustees’ approval and underwriting at the time of reentry. Commissioners asked how the county might build reserves; Costa described care‑management programs in the pool (concierge services, Teladoc/virtual primary care, diabetes management like Livongo, elective‑surgery networks that reduce costs) and said NCHIP is implementing utilization and specialty‑drug controls (noting GLP‑1 drugs such as Ozempic and Mounjaro as major cost drivers). Costa said run‑out claims (incurred but unpaid claims) could total about $200,000 if Caswell left the pool immediately and that the county would remain responsible for that run‑out if it exited.

Practical timeline: Costa said the county must decide whether to remain in NCHIP within roughly the next 30 days so that March planning and April testing with the vendor (Businessolver) can occur; final plan design and employer/employee rate splits are typically needed by the end of March to support a May open‑enrollment start.

Why it matters: Commissioners said the pool’s 6% cap and the protection against one‑year spikes made NCHIP attractive; several commissioners asked the county manager to gather broker quotes for comparison before the next meeting. The board deferred a final vote; the county will revisit the renewal and any budget implications at the February 17 meeting.