Gratiot County approves health‑insurance plan design after consultants warn of 27% renewal increase

Gratiot County commissioners voted to accept the health care committee’s recommended health‑insurance plan designs for the 2025–26 plan year, following a presentation from ACRASure representative John O'Connor outlining a roughly 27% rate increase from the county’s current carrier.

The committee recommended continuing to offer three plan tiers — a $100‑deductible PPO (the county’s current “richest” plan), a $500‑deductible HMO option and a high‑deductible HSA plan — with employee cost shares returning after a year when no cost share applied. Commissioner George (mover) and Commissioner Tim (support) made and seconded the motion; the motion carried.

The recommendation followed a detailed briefing by O'Connor, who said Blue Cross Blue Shield quoted a renewal that reflects market pressure after the county returned to that carrier from a level‑funded/self‑funded arrangement several years ago. "With regards Blue Shield this year, we've been seeing increases of about 27%," O'Connor told commissioners. He said an HRA and a pharmacy program helped reduce the renewal but not enough to avoid a significant increase.

Why this matters: county officials said the steep increase interacts with Michigan’s Public Act 152 hard cap mechanism — the statutory allowance used to calculate the county’s fixed budget for health benefits. O'Connor explained the formula’s modest adjustment this year (about 0.2 percentage points in the hard cap allowance) leaves the county budget rising far less than projected spending, which in turn will shift more costs to employees through higher payroll cost‑shares.

Commissioners and staff discussed specific implementation details, including the plan networks and employee education. O'Connor said the HMO (Blue Care Network) restricts coverage to in‑network providers except for emergencies and that the county will run reports showing which local doctors and specialists are in each network. Sheila (county staff), who distributed a handout with monthly and per‑paycheck cost comparisons, said the county will move health premium payroll deductions from 26 to 24 pays per year for budgeting and that open enrollment and staff education sessions will begin in September.

The health care committee picked the three‑plan structure to offer choices for employees with different needs and budgets. Commissioners asked about pharmacy costs and expensive specialty drugs; O'Connor and staff said pharmacy trend is a key driver of renewals and that pharmacy benefit management strategies and international sourcing options are being used where voluntary and appropriate.

The board’s formal action accepted the committee recommendation and authorized staff to implement the plan designs and proceed with open enrollment preparations. Commissioners indicated they will revisit the market again at the next renewal cycle.

Ending: Staff said they will provide enrollment materials and in‑person education before the plan effective date so employees can compare provider networks and expected per‑paycheck contributions.