Clinton County moves to renew 2026 health plan with Anthem after committee shifts plan design and modest employee cost-share

Clinton County commissioners approved a recommendation to renew the county's 2026 employee health insurance with Anthem's Health Sync network after the benefits committee and the county's consultant presented plan design changes and modest adjustments to employee contributions.

The benefits committee's presenter, Alan, told commissioners the county has enjoyed an average premium increase of less than 1% over the last eight years but that recent claims drove a sharp reversal. "For the entire year of 2024, we had what a loss ratio of a 138%... through the June ... that loss ratio was up to 147%," Alan said, summarizing the committee's analysis. He said the county had budgeted a 10% increase for 2026 but that a renewal with the current plan would have been much higher without design changes.

Bob Pia of LHD Benefits Consultants told the commission the committee sought competitive offers but received a single renewal from Anthem. "This is the maintaining our dual option with Anthem. But ... Anthem is what they call their Health Sync plan," Pia said, noting the Health Sync network is broader than the county's current IU Health-focused network but moves IU Health usage to a secondary benefit tier.

Why it matters: County staff said the plan change cut the renewal roughly in half from a much larger quote to about a 22% increase, a difference officials said made the renewal workable within the county's budget after some internal reallocations.

Details and impacts

- Claims history and budget: Alan said the county's recent loss ratios rose to 138% for 2024 and to 147% year-to-date in June 2025, forcing changes. The county had budgeted a 10% premium increase for 2026 but now will absorb a higher overall cost by reallocating budget items; Alan said "the county will increase its payments by over $400,000" though the county had budgeted $250,000.

- Plan design changes: Under the recommended Anthem Health Sync plan, the county will maintain a dual-option structure but IU Health providers will be covered on a tier-2 basis rather than tier-1. Pia said the Health Sync network's top providers include Ascension, Saint Francis and OrthoIndy; IU Health remains covered but as a different tier.

- Cost-sharing and specific changes: Pia and Alan outlined specific member costs in the recommended plan: a primary-care office visit co-pay rising from $35 to $40; a specialist co-pay rising from $50 to $80. Officials said out-of-pocket maximums cross-apply across network tiers so members do not face separate buckets.

- Clinic and wellness program: County-owned clinic access will remain unchanged and without a cost share for visits. Officials emphasized continued staff use of the clinic as a tool to reduce claims. Alan said employees who participate in the clinic's biometric/wellness process receive lower premiums.

- Ancillary lines: The committee recommended moving dental and vision to Anthem (replacing MetLife and VSP) for better rates and a multi-year guarantee; life insurance and other ancillary plans will remain with MetLife with no rate change.

What the board did

Commissioners moved to renew the 2026 health insurance as presented and the motion passed; the transcript records the motion and a second and indicates the board carried the action (vote tally not specified in the transcript).

Quotes

"For the entire year of 2024, we had what a loss ratio ratio of a 138%... through the June ... that loss ratio was up to 147%," Alan said, summarizing recent claims experience.

"This is the maintaining our dual option with Anthem. But ... Anthem is what they call their Health Sync plan," Bob Pia said when describing the recommended plan.

Ending

County leaders said they reallocated internal budget items to help pay for the increase and will ask employees to absorb a modestly larger share of premiums. Commissioners approved the change as presented and moved on to the next agenda item.