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St. Louis County to raise 2026 medical premiums after claims spike; changes to plan cost‑sharing recommended
Summary
County staff recommended and the board moved forward a 10% increase to 2026 medical premiums for the county’s self‑insured plan and proposed plan‑design changes (higher deductibles and increased pharmacy coinsurance) to address claims trends and a reduced fund balance.
Deputy Administrator Gottscheld briefed the board on the county’s self‑insured medical and dental plans and recommended a 10% increase in medical premiums for 2026. Gottscheld said the county moved from several years of 0% increases to a recent sequence of higher claims that reduced the fund balance; the county adopted a midyear increase earlier in the year and now recommends another 10% adjustment.
Staff proposed plan‑design changes meant to share more costs with plan users, including higher deductible levels, higher out‑of‑pocket caps, and a shift from pharmacy copays to coinsurance. Delta Dental Minnesota remains the county’s dental partner and administrative stop‑loss fees were also noted. Gottscheld said the county worked with Blue Cross Blue Shield Minnesota and Johnson Insurance Consultants and consulted the labor‑management insurance committee, which offered near consensus on the recommendations.
Commissioners recognized the magnitude of the change and applauded the health‑care subcommittee’s work; several mentioned regional consolidation in health care (a cited example was Aspirus taking over St. Luke’s) as a cost driver that raised claims costs. Commissioners asked for context and emphasized the impact of premium and design changes on employees and retirees.
Action taken: After discussion and public recognition of staff work, the board moved and voted to advance the proposal. Administration said final budget adoption will occur in December.
What remains unresolved: Exact impacts on individual employee premiums by tier, and precise levy impacts, were discussed but not read into the record line‑by‑line in this segment; administration said those details are available in the packet and staff can follow up.
