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Oconee County to seek broker study on self‑funded health coverage; estimated exploration cost $100,000–$150,000
Summary
The board discussed an RFP for brokerage services to evaluate whether the county can move from fully insured to self-funded health coverage; staff said the study would not affect employee coverage during the analysis and estimated brokerage fees for the work at about $100,000 to $150,000.
Oconee County staff told commissioners the county has issued an RFP for health-insurance brokerage services that will both provide full brokerage support and, if selected, analyze whether the county can switch to self-funded coverage.
A county staff member leading the presentation said the work so far has been "from a hundred-thousand-foot view" and that the next step is to "get in the weeds on claims" to produce a definitive cost estimate for self-funding. "This process, we will incur no coverage liability impact during this period, and also there will be 0 impact to the employee while this is continued on," the presenter said.
Staff said three firms were interviewed and one firm had been selected to begin deeper claims analysis. That next phase requires detailed claims data, contract and liability calculations, registration with the state insurance commissioner if the county proceeds, and negotiations with third-party administrators and pharmacy-benefit managers. The presenter said the work will produce an "all-in" number showing necessary reserves, annual program funding needs and secondary-market costs so the board can make a go/no-go decision.
Commissioners asked for cost details. In response, the presenter said the county's total annual health-insurance premium is "just about 5,000,000" (five million dollars) and estimated that the investigation — the brokerage fees and deeper analysis — would likely range from $100,000 to $150,000. The presenter explained the county's current brokers historically received a percentage of premium (a commission) and that under a contracted-fee model the county would pay an explicit fee instead of a commission. The presenter said a typical standard brokerage commission is about 5 percent of premium.
Staff said the broker selected through the RFP would provide full-service brokerage work — open enrollment support, claim dispute assistance and market negotiations — and that county officials expected to receive detailed findings and a recommendation before the next plan renewal cycle.
No formal board vote to adopt a procurement decision is recorded in the provided transcript; staff said results would be presented to the board next week for further direction.
Ending
If the broker recommends pursuing self-funding, staff said the county would return to the board with detailed cost estimates and a recommendation ahead of the next renewal period; if not, the county would remain fully insured.
