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Commissioners study rising employee health costs; direct staff to investigate self-funding and clinic options
Summary
Commissioners reviewed initial fiscal-year-2026 health insurance estimates showing potential double-digit increases and large claims driving costs. The board asked staff to study self-funded models, Richmond County's approach and the feasibility of an employee health clinic and asked for an update at the April meeting.
Scotland County commissioners heard initial estimates for fiscal year 2026 health-insurance costs that showed substantial upward pressure driven by large claims and overall cost trends. Commissioners directed staff to investigate alternatives, including self-funded models used by other counties and an employee health clinic, and to return with a report and further data at the April meeting.
County staff and the benefits broker presented several plan scenarios, including performance-funded options and a UnitedHealthcare alternative. The presentation noted the county currently faces a cluster of large claims: staff said there were 12 large claims in a recent month, which drove much of this year's losses; that number was said to have declined to eight at the time of discussion. The broker noted individual large claims in the hundreds of thousands of dollars had occurred in the plan year.
Commissioners raised the possibility of moving to a self-funded pool and asked staff to contact nearby jurisdictions (the transcript records an explicit instruction to call Richmond County) to learn how other counties operate self-funding arrangements and whether those models would suit Scotland County. Commissioner discussion also raised the idea of establishing an employee health clinic to treat minor conditions and provide preventive care; staff said such a clinic could reduce small claims and help manage overall costs if the county billed insurance for clinic services.
The board asked the county's benefits broker and staff to gather more data on the new "self-funded" column proposed in the broker's options, to model what Scotland County's claims experience would have produced under a self-funded arrangement, and to confirm the practical steps and risks. Commissioners agreed the information should be returned to the board at the regular commission meeting on April 7.
No formal vote was taken on plan selection during the meeting; commissioners discussed possible employee cost-sharing and participation models but did not adopt a policy change at this session.
