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County's health plan renewal keeps employee premiums steady; specialty drugs drive claims up
Summary
County consultant Mark Bridal told commissioners the county's self-funded health plan posted positive positions in prior years, saw claims rise about 11% this year driven by cancer and specialty pharmacy, and recommends keeping Cigna as administrator and raising pooling level from $125,000 to $175,000 to reduce premiums.
Mark Bridal, presenting an employee benefits update on behalf of the county's benefits team, told the Person County Board of Commissioners on May 19 that the county's self-funded health plan remains in a generally positive position but is seeing rising claims.
Bridal said the plan had positive results of about $550,000 in 2022-23 and about $390,000 in 2023-24; for the current plan year he reported claims are up roughly 11%, with cancer treatments and specialty pharmacy spend as the main drivers. Specialty pharmacy spend is up roughly 32% this year, Bridal said.
On the 2025-26 renewal, Bridal reported a successful bid that left the county with a net positive from Cigna of about $150,000 and said the county should not need to change administrators. He recommended raising the pooling level from $125,000 to $175,000 to reduce premiums; Bridal said that change is expected to save the county roughly $219,000 (presenter's phrasing) and would not change member benefits.
Bridal also said pharmacy-contract improvements and pass-through pricing should yield more than $500,000 in pharmacy rebates back to the plan across the current and next year. He told the board there will be no premium increase for employees in 2025-26 and described county wellness programs for diabetes and weight management as producing lower claims for participating employees.
The presentation was informational; no formal vote was recorded on benefits at the May 19 meeting.
Quotes from the meeting - "For the current year, claims are up about 11%. The drivers for that are cancer and specialty pharmacy spend," said Mark Bridal, benefits presenter. - "For the 25-26 plan year, the plan was bid, and the result was very positive," Bridal said, describing the renewal outcome.
Clarifying details in the transcript included the prior combined positive position of roughly $900,000 across two years and the estimate that increasing the pooling level and the renewal result together produce a modest net funding impact (county contribution up about 3%). The board asked no formal policy change; the item was informational.
