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Durham County keeps Cigna for 2025'26 health plan after RFP; pharmacy guarantees reduce projected cost
Summary
After a competitive RFP, county staff recommended staying with Cigna for the self-funded health plan and securing improved pharmacy cost guarantees; staff warned that medical claim frequency, high-cost specialty drugs and stop-loss renewals are driving projected benefit cost increases of roughly $6.3 million for 2025'26.
Durham County benefits staff told the Board of Commissioners on May 13 that a competitive request for proposals (RFP) covering medical administration, pharmacy benefit management and stop-loss insurance produced better pricing and stronger performance guarantees from incumbent Cigna.
Chief human-resources and benefits staff said the county keeps a self-funded medical plan where the county pays claims below a stop-loss threshold and buys stop-loss insurance for catastrophic claims (current attachment point $225,000). The county received multiple proposals for medical administration, pharmacy benefits and stop-loss coverage and evaluated total cost, provider network access and…
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