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Crown Point board adopts 2026 health-plan renewal, opts for higher stop‑loss attachment to save premiums
Summary
The board approved renewal option 2 for the city's employee health plan, a choice the city consultant said will lower fixed premium costs but modestly increase the city's exposure for very large claims; the board also separately approved the PBA plan-administrator contract.
The Crown Point City Board of Public Works and Safety on Nov. 5 approved the city's 2026 employee health-plan renewal, selecting the consultant's recommended option that raises the specific stop-loss attachment in exchange for lower premium costs.
Rick, the city's employee benefit consultant, told the board the renewal process was unusually difficult. He summarized the recent loss history: a 493% loss ratio in 2023, a 67% loss ratio in 2024, and a year-to-date ratio of about 120% expected to mature to 137%. That three-year composite was described as approximately a 220% non-mature loss ratio. Market outreach yielded only the incumbent carrier's renewal proposal.
Rick presented two options and recommended option 2, which increases the specific stop-loss attachment (raising the employer's exposure on very large claimants) but achieves about $180,331 in annual premium savings compared with keeping the $100,000 specific deductible. He said the option 2 scenario results in an approximate 8.8% plan premium increase overall but a lower fixed cost than option 1 when factoring in premium savings tied to higher attachment.
He described mitigation steps the city has already pursued: the Samaritan Fund program, a 501(c)(3) trust the city has used to subsidize premiums and out-of-pocket costs for identified large claimants, and outreach to secure direct contracts with large providers (example referenced: Rush University Medical Center) to reduce network costs. The consultant said the Samaritan Fund application has been submitted for six of seven known large claimants and that efforts are underway to find marketplace or direct-contractor solutions to lower future claims.
Board members asked procedural and timing questions; staff said the renewal takes effect Jan. 1, 2026. The board voted to adopt renewal option 2 and, in a separate motion, approved the PBA plan-administrator contract.
