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Eaton County committee backs benefit renewals, recommends PA 1 52 override and biosimilar drug strategy
Summary
The Ways and Means Committee authorized county staff to sign benefit renewals with Blue Cross Blue Shield and Delta Dental and recommended the full board pursue a PA 1 52 override setting employee cost-sharing tied to COLA; members also approved pursuing a biosimilar strategy projected to reduce pharmacy costs.
The Eaton County Ways and Means Committee on Oct. 8 authorized the controller’s office to sign annual benefit renewals with Blue Cross Blue Shield and Delta Dental and voted to send a recommendation to the full county commission that it adopt a PA 1 52 override to set local cost-sharing rules.
Deputy Administrator and Human Resources Director Ben told the committee that administration negotiated expected renewal rates that reduce the county’s exposure compared with Blue Cross’s earlier illustrative rate. ‘‘The total change in the combined health insurance for the county was 6.8%,’’ Ben said, contrasting that with an illustrative 22% increase the carrier initially reported. He recommended the county adopt expected rates and seek the PA 1 52 override so the county can set its own employee cost-sharing rather than accept the statutory hard cap or a mandatory 80/20 split.
Under the administration’s recommendation, employees’ premium increases would be tied to the cost-of-living adjustment (about a 5% increase of the employee’s prior-year premium share), while the employer share would rise about 6.9%. Ben said the recommendation would not require a budget amendment now because the county budgeted for a larger increase.
The committee voted by voice to authorize moving the renewal and override recommendation to the full commission, where a two-thirds majority is required to adopt the override.
Committee members also approved a recommended pharmacy strategy to prioritize biosimilar biologic drugs, a change presented by Brown and Brown and Blue Cross’s pharmacy division. Administration estimated the biosimilar priority could yield up to $2,250,000 in year-one savings depending on rebate outcomes and actual claims, but Ben cautioned any savings would be reduced if many members need name-brand drugs and obtain medical exceptions. ‘‘If these prove ineffective, we have no savings whatsoever,’’ the chair noted during discussion.
Ben said the biosimilar change would not remove coverage; it would prioritize biosimilars at the pharmacy level with an exceptions process for members who experience adverse reactions or need brand drugs for medical reasons. The committee approved moving forward with employee and union notifications and set an implementation goal of Jan. 1.
The committee also authorized staff to renew dental and vision plans where applicable and to lock administrative fees where favorable. Ben told commissioners the county uses a three-year vendor review cycle and that Brown and Brown serves as broker for procurement and compliance.
What happens next: The Ways and Means Committee has forwarded the PA 1 52 override recommendation to the full Eaton County Commission for a vote. If the full board fails to secure a two‑thirds majority, the county would fall back to the other statutorily permitted options (an 80/20 split or the hard statutory caps) or pursue a different cost-sharing plan.
