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Budget workshop: insurance options, EMS staffing and dispatch costs discussed
Summary
At a budget-focused portion of the Kossuth County meeting, the county’s broker outlined a benchmark health plan and a potential embedded high-deductible plan; ambulance leadership presented staffing shortages and a proposed $60,000 share for dispatch operations.
Supervisors devoted significant time Jan. 21 to ongoing budget items, reviewing health-plan options and the ambulance service’s operating needs as the county prepares its fiscal 2026 budget.
Insurance options Michelle, the county’s insurance broker, presented a comparative analysis of the county’s current self-funded plan and a suggested benchmark (Alliance Select 2) that would increase member cost-sharing in office visits and add an emergency-room co-pay that could be waived if the visit leads to hospital admission. She recommended the county consider an embedded high-deductible health plan (HDHP) that would meet IRS/HSA minimums (single deductible at the federal minimum and a family embedded structure) if the board wants to offer employees a buy-up option.
Michelle said the county’s current plan is comparatively generous and that offering an HDHP alongside a benchmark plan would require the board to incentivize employees to choose the HDHP (for example, via employer HSA contributions covering some of the premium difference). She noted a preliminary model showing a projected annual savings (rough order of magnitude) if the county adopted a benchmark plan closer to peers; the broker will return with side-by-side 2-way and 4-way rate comparisons for the Alliance Select 2 and a quoted embedded HDHP with suggested employer HSA contributions.
EMS budget and operations Phil, who presented the ambulance budget, reported year-to-date fund metrics and said the department is experiencing recruitment challenges for paramedics and EMTs. He said his advisory council will review wages and staffing models and that he is exploring options including a potential staff-size increase from nine to ten positions. Phil said the city of Algona has requested a new $60,000 contribution toward the shared dispatch center; supervisors flagged that the request and the allocation of training-complex utilities are unresolved budget items.
Phil reported a current fund balance of roughly $1,000,000 and projected it at about $700,000 at the end of the fiscal year after planned vehicle replacement and expected expenditures; he said the department plans to use $100,000 from ARPA funds toward an upcoming vehicle purchase and will continue to review staffing and operational schedules to remain competitive.
Next steps Michelle will provide a side-by-side spreadsheet showing the county’s existing self-funded plan, the benchmark plan (Alliance Select 2) with a quoted emergency-room co-pay waiver-if-admitted, 2-way and 4-way rate comparisons, and an embedded HDHP quote (33100/66100 structure suggested) with sample employer HSA contributions. The ambulance director will return with the advisory council’s wage recommendations and a plan for recruiting and training to address paramedic shortages.
Ending Supervisors did not adopt benefit changes at the meeting. They asked staff and vendors for detailed comparative pricing and wage recommendations to inform final budget decisions in February and March.
