Bourbon County commissioners review health plan options, staff warn employees could face higher out-of-pocket costs

Bourbon County commissioners spent their work session reviewing proposed changes to the county’s employee health insurance, hearing detailed plan comparisons from county staff and public commenters and asking the county’s broker to supply side‑by‑side cost comparisons before a final decision.

Susan, the county clerk, told commissioners that 74% of employees are enrolled in the county’s Plan A and that the proposed 2026 options raise deductibles and increase coinsurance. “Plan A has a deductible of $1,000 for individual, and $2,000 for family, with a maximum out of pocket of $5,000 and $10,000 for family, with a 20% coinsurance,” she said, then summarized proposed changes: higher deductibles (up to $3,500 in the best new option) and coinsurance that would rise from 20% to 40% on some services.

The clerk also outlined premium figures and alternatives. She said employee‑only premiums the county has covered at about $902 would be near $836–$844 for certain health savings account (HSA) options and that the current employee‑plus‑spouse premium is about $1,938.45. She described HSA plans the broker identified as lower‑cost alternatives and said the county could consider fixed employer HSA contributions rather than the previous practice of promising to pay a full premium for single coverage.

Commissioner Milburn said he favored the broker’s recommendation for a fixed employer contribution to provide predictability: “I would definitely like to take Mr. Doherty’s recommendation and do a fixed contribution,” Milburn said. Other commissioners said they wanted to see the full numbers before deciding and expressed concern about shifting costs to employees and potential turnover.

Multiple county employees and residents spoke during the session, describing higher out‑of‑pocket costs for prescriptions and medical care since the county left the state plan. One resident said, “I feel like we got all of us got screwed when we went from the state,” characterizing employee frustration and concern about retention.

County staff presented budget figures to place the insurance discussion in context. The clerk said the total employee benefits budget is approximately $2.585 million this year and projected $2.669 million next year, and she said the county’s health coverage line item had been budgeted around $1.44 million this year. Staff told commissioners the present proposal would leave a gap roughly in the low six figures; the clerk said the budget was short by about $100,000 relative to what had been set aside for health costs, and later staff estimated a shortfall “about $130,000.”

Commissioners asked the county’s broker team to supply missing comparisons and to confirm rates for medical, dental and vision plans. Don Doherty, the insurance broker, joined by phone and agreed to pass along a single comparison sheet showing before‑and‑after premium amounts and to follow up about dental and vision rates.

No formal decision or vote was taken at the work session. Commissioners said they planned to keep gathering information and to decide before open enrollment closes. Staff cautioned that open enrollment timelines are tight and that enrollment materials must be ready for employees and integrated with the county’s payroll system.

The discussion also covered plan design tradeoffs: staff described level‑funded plans, which shift some risk to the county, and fully insured plans, which carry fixed premium costs. Commissioners discussed offering multiple enrollment options, employer HSA contributions for employees who select HSA plans, and whether to pursue different vendor quotes if the proposed renewal terms remain unfavorable.

The county did not record any motion or vote during the session. Commissioners directed staff and the broker to provide: (1) a single, side‑by‑side comparison of current and proposed premiums for Plan A and Plan B; (2) dental and vision renewal numbers; and (3) alternate carrier quotes or negotiated best offers as soon as possible so the board can finalize enrollment decisions before the county’s open enrollment deadline.