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Committee recommends raising Rutherford County medical stop‑loss retention to $600,000
Summary
County staff recommended raising the self‑insured medical stop‑loss retention to $600,000 with an accompanying rate; the procurement committee approved forwarding the recommendation to the full commission.
Rutherford County procurement committee members heard staff recommend raising the county's medical stop‑loss retention (the dollar threshold above which an insurer reimburses catastrophic employee medical claims) to $600,000 and adopting a vendor rate of $39.75.
Ed (staff member) told the committee the county has been self‑insured up to a contract'specific retention and that the recommended change increases that retention over time. "So this is medical stop loss ... we're recommending to raise it to 600,000," he said, explaining the county's broker performed Monte Carlo analyses across a large client set and recommended the $600,000 level as the best balance of premium cost and risk.
The recommendation reflects a multi‑year trend staff described to the committee: a $300,000 retention in 2023, $400,000 in 2024, $500,000 in 2026 (as presented), and the present recommendation to set the retention at $600,000. Ed noted the change shifts more near‑term risk onto the county but, based on claims history (one large claim in each of the last three years), appeared more predictable than lower retentions. He also cautioned about "lasering" — insurers excluding a recurring high‑cost individual from coverage — and said no such exclusions were applied to the county's current portfolio.
Mr. Hill (staff member) presented the formal recommendation from the insurance and budget committees and moved to approve the change and the proposed rate of $39.75. The committee took the motion, called the roll, and recorded the vote in favor; committee staff said the item will proceed to the full commission for final action.
Why it matters: Raising the stop‑loss retention generally reduces insurer premiums but increases the county's exposure to a single large claim. Staff told the committee the recommendation was driven by broker modeling, recent year claim experience and committee review.
What happens next: The committee voted to forward the recommendation to the full Rutherford County commission for final approval.
