Scotts Bluff County commissioners on June 27 approved a six‑month stop‑loss and group health insurance arrangement with Sun Life, voting 5-0 to switch claims coverage for high-dollar claims while the county re-evaluates its long-term approach.

County staff presented the board with competing 12‑month and six‑month reinsurance proposals and said several recent large claims have depleted the county’s self-funded reserves. "As you know, we've been working — this is what we go through every year this time of year," Lisa Testa, county staff member, told the board as she introduced options from the incumbent stop‑loss administrator, RCI, and alternative proposals including Sun Life and other reinsurers.

Testa said the county currently carries a $80,000 specific deductible (the county pays the first $80,000 of an individual claimant’s costs and the stop‑loss carrier covers amounts above that). She said last year the county raised the deductible from $60,000 to $80,000 after a year with several high claims and that claims experience has not yet improved.

The county received 12‑month fixed‑cost quotes that varied substantially: staff noted a prior planned fixed cost of about $809,000 would have increased to roughly $937,000 under one 12‑month proposal while other carriers provided different mixes of fixed cost and "lasers" (higher specific deductibles for named high‑cost individuals). RCI produced a counteroffer that reduced its fee but still included a laser on at least one covered individual. Staff reported a six‑month proposal from Sun Life with a fixed cost near existing levels (roughly $400,000 for the six months) and an embedded terminal liability/transition cost (described in staff materials at about $50,000) to cover runoff claims if the county changes carriers again at year‑end.

Lisa Testa said she met an independent broker, Ian Shada of Alliance Services, who recommended a six‑month term to allow the county to solicit broader options at the start of a calendar year and evaluate alternatives such as level funding or joining a larger pooled or fully funded plan. Testa recommended moving to Sun Life for the six‑month period while staff assesses restructured options.

Board members raised several technical concerns during the discussion, including:

- The use and impact of "lasers" that assign substantially higher specific deductibles for identified high‑cost claimants, which can shift more immediate risk back to the county.
- Provider pricing and reference‑based pricing: Testa and the broker argued the county’s payments on some claims were well above typical Medicare multiples; staff reported providers sometimes charge several times Medicare rates and that negotiation, network access and repricing (through networks such as Cigna) are major drivers of cost.
- Continuity of coverage and terminal liability: commissioners asked whether a carrier change could leave the county exposed to uncovered runoff claims; staff said Sun Life’s six‑month offer included terminal liability protections during the transition.

After discussion, Commissioner (unnamed in transcript) moved to approve the Sun Life six‑month renewal; another commissioner seconded. The motion passed on a roll call count reported as five yeas, with no recorded nays or abstentions.

The board’s action is for a short, transitional contract: staff said they will continue working with RCI for claims administration during the six months while Sun Life would serve as the stop‑loss carrier for covered claims above the $80,000 deductible. Staff also told the board they plan to reopen bidding and evaluate options for the next renewal window and to report back with recommendations.

Why this matters: the county’s self‑insured health fund has absorbed several large claims, staff said, and rising fixed costs for stop‑loss protection would consume reserves. The six‑month approach aims to limit immediate cost increases while giving staff time to seek broader market options and potential structural changes to the plan.

Next steps: staff will finalize the Sun Life contract terms to start July 1, continue claims administration and evaluation, and return to the board with competitive proposals for the longer‑term approach during the six‑month review period.