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Rankin County hears health insurance renewal; broker reports 7.7% net increase, pharmacy carve-out concerns
Summary
An insurance broker told the Board that renewal underwriting produced a preliminary 17% increase from the incumbent, leveraged down to an estimated 7.7% increase overall; pharmacy carve-out and two high-cost claim 'lasers' were highlighted as issues for future planning.
Rankin County officials on Dec. 2 reviewed the county’s employee health insurance renewal and were told the plan faces higher underwriting costs for 2025, with an estimated net increase of about 7.7% after negotiations.
Mickey Watkins, the county’s insurance representative, told supervisors that the county’s plan is self-funded and that per-member-per-month claims ran about $451 this year. “You all are self funded health plan… y’all were paid about about $451 for every single person that’s covered on your plan per month,” Watkins said. He reported approximately $14.6 million in paid retail claims (medical claims only, excluding pharmacy) and said the county’s Blue Cross Blue Shield arrangement yields about a 72% discount through negotiated rates.
Watkins said he solicited reinsurance renewal quotes widely — 16 carriers were approached; several declined or dropped out during underwriting — and that the incumbent insurer initially proposed a roughly 17% increase. After further negotiation and a competitive quote, Watkins said he was able to leverage the renewal down to a 7.7% increase overall. He added that Blue Cross did not increase the county’s administration fee this year and noted two “lasers” (high-cost claim carve-outs) on the renewal covering two members: one at $200,000 and one at $140,000.
Watkins also raised concerns about a pharmacy carve-out. He said Blue Cross has begun, or planned, changes that could require pharmacy coverage to be managed separately, which could mean employees carrying two ID cards and uncertainty at the start of the plan year. “The Blue Cross Association will not allow them to put another logo on their ID card. So your employees would have to carry 2 ID cards, 1 for medical, 1 for the pharmacy,” Watkins said, urging the board to avoid being an early “guinea pig” for any untested pharmacy carve-out and suggesting revisiting options mid-year once the market and vendors settle on approaches.
Board members asked questions about membership counts and plan design. Watkins clarified the claims and member counts were based on 10 months of data and that pharmacy was excluded from the claim totals he cited. He recommended monitoring the pharmacy developments and revisiting third-party pharmacy arrangements when more information becomes available.
The board added on the agenda authority for County Administrator Keith and the board president to sign renewal documents for Blue Cross Blue Shield and reinsurance policies, a motion that passed by voice vote.
No formal vote on plan design or carrier changes was recorded beyond granting signature authority; Watkins and staff said they will present additional details as final underwriting completes and if further decisions are required.
