Hamilton County approves Anthem renewal; raises retiree contribution and modest retiree premiums

Hamilton County commissioners approved the county's renewal with Anthem and accepted the insurance committee's recommendation to increase the county contribution for post-65 Medicare Advantage retirees from 72.4% to 75%.

Human Resources Director Sheena Randall, joined by Katie Sowers, presented the renewal paperwork and the plan details. Staff said Anthem proposed roughly a 6% overall renewal for 2026; the county negotiated pharmacy contract terms last year that continue to provide increased rebate savings. Randall said the retirement-plan premium changes stem from a combination of claims experience and recent Centers for Medicare & Medicaid Services (CMS) adjustments that lowered out-of-pocket pharmacy maximums, improving benefits while increasing premiums.

The insurance committee recommended the county increase its contribution level for the Medicare Advantage retiree plan, which staff estimated would create a budget impact of about $247,000 for the county. For plan participants, staff said the adjustment would raise monthly retiree premiums by approximately $30 for single coverage and $62 for employee-plus-spouse coverage, bringing those premiums to $109 and $219 respectively. Commissioners approved both the retirees contribution change and the overall Anthem renewal.

Staff scheduled a meeting with retirees and Anthem to explain the changes and answer questions; that session was set for Thursday at 12:30 p.m. county staff emphasized the county has budgeted for the change and that the increase keeps retiree premiums well below pre-Medicare Advantage levels.

Commissioners and staff noted the broader pharmacy marketplace is changing and signaled they will ask the insurance committee to examine pharmacy strategies in early 2026.