Cole County renews stop‑loss reinsurance with Sun Life; approves employee share and one‑time transfer to insurance reserve

Cole County Commissioners on Oct. 28 approved renewing the county's stop‑loss (reinsurance) contract with Sun Life for the 2026 plan year and moved several related funding and employee‑cost decisions into the proposed 2026 budget. The renewal keeps the county's specific deductible at $85,000 and maintains a $1,000,000 aggregate umbrella and a contract provision that prohibits "lasering" (individual exclusions) at renewal.

The renewal vote was taken after a benefits consultant reviewed plan mechanics and renewal options. The consultant said Sun Life offered the most favorable market terms for continuity and contract protections, and that the county's stop‑loss premium for the $85,000 specific level renewed at roughly a mid‑single‑digit to low‑double‑digit increase on the fixed stop‑loss premium (presented in the packet as a 9.39% premium increase for the specific coverage). The consulting presentation showed an alternative option that would raise the specific deductible to $100,000 with a lower premium but would shift about $15,000 more per covered claim back to the county.

Why it matters: The county is self‑funded for medical and pharmacy and buys stop‑loss insurance to cap large claims. In recent months the county's health insurance fund balance has fallen to about $1.3 million and staff said the fund has been drawn down by roughly $100,000 per month. Actuarial guidance in the packet suggested a higher per‑employee set‑aside (the presentation cited ~$770.39 per employee) while the county currently sets aside about $694 per employee. County staff told commissioners that without action the fund's reserves could become uncomfortably low and that building the reserve is a budget priority.

What the commission approved and budget direction:…