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Ramsey County hears Blue Cross estimate: stop-loss premiums to rise about 7% for next plan year
Summary
County staff and a Blue Cross representative reviewed health-plan renewal options, including retaining a $20,000 stop‑loss, moving to non‑grandfathered plans and the effects of a closed prescription formulary; commissioners were given an October 31 deadline to lock rates.
Ramsey County Commissioners heard a presentation from a Blue Cross representative reviewing the county’s employee health‑insurance renewal and stop‑loss options. The presenter said if the county keeps its existing $20,000 stop‑loss level and stays on its grandfathered Classic Blue plan, the annual stop‑loss premium would increase by about 7 percent.
The county was shown three main choices: remain on the grandfathered Classic Blue plan; move to a comparable non‑grandfathered plan labeled “Your Blue” (which raises the deductible modestly but combines medical and prescription out‑of‑pocket limits); or change stop‑loss attachment levels (examples quoted at $30,000 and $50,000) to reduce monthly stop‑loss premiums while shifting more risk to the employer. The presenter said administrative fees had been reduced in the quotes from 9.9 percent to 8.9 percent.
Why it matters: commissioners must set coverage and funding choices before the insurer’s deadline to keep the quoted rates. Moving off a grandfathered plan would add preventive‑care benefits (for example, coverage of routine mammograms, PAPs and preventive colonoscopies) but could modestly increase employer funding needs and raise employees' initial deductible by roughly $250 on the quoted plan.
Supporting details and numbers presented: Blue Cross quoted a roughly 7 percent increase in the $20,000 stop‑loss premium under current plan designs. If the county chooses to “fund” stop‑loss at the suggested level rather than pay only the premium, the presenter gave illustrative funding increases in the 9.8–10.4 percent range depending on options and funding level. The presenter estimated eight county plan members would be affected by changes under the proposed closed formulary, with an annual estimated savings to the group of about $13,000 if nonformulary 50% coinsurance sanctions are reduced by moving to a “net results” formulary design.
Commissioners asked about timing and next steps; the presenter said the county would need to decide by Oct. 31 to preserve the quoted pricing and avoid potential free‑rating. Commissioners and staff discussed tradeoffs between preserving the grandfathered plan (no immediate change for members) and shifting to a non‑grandfathered plan to capture added preventive benefits at somewhat higher employer cost. No formal vote was taken at the meeting on plan selection.
The presentation also noted that the quotes did not include GLP‑1 medications for weight loss (diabetes GLP‑1 coverage could be handled separately) and that adding GLP‑1 coverage would materially raise costs. The representative described a recent state requirement affecting drug cost allocation to out‑of‑pocket limits and said the proposed “net results” formulary change aims to reduce employer exposure on nonformulary claims.
The presenter offered to provide follow‑up materials and attend additional meetings, and commissioners requested the additional information needed to finalize the county’s choices before the insurer’s deadline.
