Douglas County approves one-year health plan renewal, keeps employee costs flat

The Douglas County Board of County Commissioners voted 5-0 on April 16 to approve recommended health plan changes and a stop‑loss renewal for the June 1, 2025–May 31, 2026 plan year, keeping employee contribution rates the same and using reserve balances to absorb a projected funding increase.

County staff told commissioners the most recent full plan year ended about 6.5% under projections after stop‑loss reimbursements, a trend they credited to employee engagement with existing programs. Medical claims were reported roughly 3% higher than the prior year but still below national trend. Prescription costs rose about 14% year over year; staff attributed much of that increase to higher utilization of GLP‑1 weight‑loss drugs.

Michelle Sprear, benefits staff, said the county’s stop‑loss deductible for any individual is $195,000 and that stop‑loss premiums had renewed favorably; she and consultants recommended renewing stop‑loss coverage with Optum. Staff recommended keeping employee premiums and plan deductibles unchanged for one more year and using fund reserves to cover the county’s share of an estimated funding gap rather than increasing employee costs now.

Staff proposed targeted benefit changes: adding a no‑cost virtual mental‑health option through First Stop Health available to employees and immediate family members; raising chiropractic reimbursement to $40 per visit and increasing the annual visit cap (staff suggested 26 visits); and modestly increasing health reimbursement account (HRA) seed amounts to $300 for individual coverage and $600 for other coverage levels (previous amounts were described in the meeting but not listed on the record for publication). Staff also proposed a second round of the “roadmap for wellness” pilot and a request to issue a request‑for‑proposals for third‑party administrator services after renewal.

Brooke, who manages the county’s benefits fund, reported the county has several sources of cash and a combined balance staff said is sufficient to continue a one‑year approach of using reserves rather than raising employee contributions. Consultants from Willis Towers Watson had been used to benchmark funding and run renewal scenarios.

Commissioners asked about long‑term trends, drug pricing, and whether prescription cost‑sharing designs (for example, percentage copays) should be reconsidered in future years. Staff said those design options would be evaluated for the next plan year and that they would return with additional analysis and an employee benefits survey to inform future changes.

The motion to approve the plan changes and stop‑loss renewal with Optum passed unanimously. Staff said formal renewal and contract steps will follow ahead of the June 1 effective date.