Columbia County adopts four-tier health plan and sets higher employee contribution for 2025 renewal

Columbia County commissioners voted to adopt a four-tier health insurance structure and to increase the county's budget contribution for employee benefits after a detailed presentation on medical claims and renewal pricing.

The action came after Tyson, a consultant with Gallagher, presented renewal data showing higher-than-expected claims and a sequence of proposed and negotiated rate adjustments. Commissioners voted in favor of both the shift to four coverage tiers and a motion to raise the county's budget contribution by $150,000 to support employee premiums; both measures were approved by voice vote with no roll-call tallies recorded.

Why it matters: Gallagher's renewal analysis showed the group's medical loss ratio climbed sharply in the most recent months, driven in part by a rise in high-cost claimants. That deterioration pushed an initial insurer renewal request above 20 percent; negotiation and plan design changes brought a recommended county-level increase down to about 11.3 percent under the proposed four-tier option. Commissioners said the change is intended to give employees more affordable options and to improve recruitment and retention.

Tyson told the board that the county's medical loss ratio was about 76.57 percent through February and rose to roughly 92 percent in a later 12-month review, noting the change was driven by an increase in "high-cost claimants." He said the insurer's initial proposal would have been a 21.4 percent premium increase if plans stayed the same, and that negotiation plus a recommended plan swap (replace plan 317 with plan 3564) brought the proposed final increase to 11.3 percent on current enrollment. "The higher the claims, the higher the premiums," Tyson said, explaining components that feed a renewal: paid claims, excess-risk pooling and carrier overhead.

Staff and consultants reviewed several design options. The committee recommended replacing an older low-participation plan ("Blue Choice 317," also referenced as Plan A) with Plan 3564 and moving from a two-tier structure (employee / family) to four tiers (employee only, employee + spouse, employee + child, family). Gallagher and county staff showed enrollment counts by plan and estimated biweekly payroll deductions under the new structure. Anne Edenfield of Gallagher joined Tyson during the presentation and answered implementation questions.

Commissioners and staff discussed the sheriff's office and other constitutional offices, which currently handle contributions differently; the sheriff's office was described as budgeting a lump sum and spreading that amount across its employees, while the City of (Jacksonville) was noted as paying a flat 75 percent of premium regardless of tier. Commissioners asked about possibilities of consolidating or joining other employer groups in the future; staff said the sheriff's office would need to provide claims and demographic data before carriers could model combined pricing and that such a change was not feasible for the current open-enrollment cycle.

The board also reviewed ancillary renewals. Dental claims rose after a recent enhancement (adding a higher buy-up plan), producing an initial 15 percent renewal request that staff negotiated to 12.1 percent; staff said that equates to roughly $24,000 annually and will be shared between county and employees based on current contribution policy. Vision, life and disability renewals were discussed with no rate increases reported for vision or core life coverage; the county amended short-term disability contract language to remove a requirement that employees exhaust paid time off before qualifying, at no additional cost.

Action and next steps: The board voted to adopt the four-tier plan and to increase the county's budgeted per-employee contribution (moving the budgeted per-employee amount from about $10,600 to $11,000, per staff recommendation) by adding $150,000 to the benefits budget. Staff said open enrollment materials will be finalized immediately so employees can review plan options, and Gallagher and HR staff plan multiple after-hours enrollment sessions for employees and spouses. Commissioners also asked staff to produce comparative analyses later (for example: sheriff's office vs. county vs. state coverage) if additional consolidation or cross-coverage proposals arise.

Quotes (attributed): "The higher the claims, the higher the premiums," Tyson said when explaining how claims and contract negotiations drive renewal rates. "We've talked about this for three years now," Commissioner Rocky said while urging staff to keep pushing for transparency and comparative data from the sheriff's office. "If you choose plan C and employee spouse, there's a rate associated with that. That's what you'll pay minus the county's contribution," Tyson said while explaining the four-tier structure and payroll deduction mechanics.

The board directed staff to proceed with open enrollment under the new plan structure and to continue discussions about long-term options, including possible consolidation with other employer groups if the sheriff's office and other entities provide the claims and demographic data carriers need for modeling. Staff also committed to hold employee education sessions and to supply a follow-up comparison of employer contributions and coverage options for future consideration.

Ending: County staff will finalize enrollment materials and plan documents for distribution in advance of open enrollment, and Gallagher will assist with employee education events. Commissioners asked that staff return to the board with any new modeling or cost-sharing options developed before next year's renewal cycle.