Cole County Commission renews Sun Life stop-loss coverage, approves employee contribution and budget measures for 2026

Cole County commissioners on Oct. 28 voted to renew the county's stop-loss reinsurance with Sun Life at a $85,000 specific deductible and approved a package of changes to employee benefit funding included in the proposed 2026 budget.

The actions approved by the commission included renewing the Sun Life stop-loss contract at the existing $85,000 attachment point, directing staff to implement an employee contribution of $25 per pay period for the preferred provider (PPO) option and a $25 per-pay HSA contribution, and absorbing a 6% increase in the county's employer-paid dental premium. The votes were taken by voice and passed after staff presented renewal terms and fund projections.

Why it matters: county staff said medical and pharmacy costs have risen sharply and are depleting the county's health insurance reserves. Finance and HR staff reported the county's current payroll set-aside (about $694 per employee) is below actuarial recommendations, producing a recent operating deficit in the self-insurance fund. Staff recommended a 20% increase to the per-employee charge assessed to county departments (from roughly $694 to about $858) and proposed a one-time transfer of marijuana sales-tax proceeds to the health fund to rebuild reserves.

Key details from the presentation: county advisers and benefits staff reviewed the stop-loss policy and marketplace options. The Sun Life renewal was presented as the most favorable market option because it includes a no-new-lasering provision and a contract renewal rate cap; the carrier's Choice Plus (UnitedHealthcare) network was identified as the plan network. Staff showed a stop-loss premium increase of about 9.4% to maintain the $85,000 specific deductible. An option to raise the specific deductible to $100,000 was presented as potentially attractive on premium savings but would shift about $15,000 more risk per large claim back to the county.

Staff also described aggregate coverage that protects the plan if combined claims below the specific deductible exceed a set attachment point; that layer was shown with an expected increase of roughly 12% in the attachment point this year.

Budget and reserves: HR and finance staff said the county's health insurance fund balance has fallen in recent months and that medical and Rx spend has outpaced the amount being placed into reserves, producing an operating shortfall. Staff proposed a combination of measures: (1) renew stop-loss with Sun Life at $85,000 to preserve contract continuity and the no-lasering protection; (2) increase the departmental per-employee charge by 20% in 2026 to begin rebuilding reserves; (3) set a $25 per-pay employee contribution and $25 HSA payroll contribution for employees; and (4) consider a one-time transfer of approximately $580,000 in marijuana sales-tax proceeds into the health fund as a bridge to stronger reserves. Open enrollment for the new plan year begins Nov. 1 and the county's budget recommendation is due Nov. 15.

Commission discussion focused on tradeoffs between benefits and wages, distributional effects across departments ("winners and losers" depending on each department's claims experience), and employee participation in voluntary cost-containment programs. Staff noted specialty drug costs (for example oncology infusions and newer GLP-1 and biologic therapies) as a major driver of the rise in claims.

Formal actions taken: the commission moved and passed renewal of the Sun Life stop-loss contract at the $85,000 specific deductible and approved the employee contribution and HSA contribution levels proposed by staff, along with the county absorption of the dental premium increase. Staff will proceed with open-enrollment communications and finalize budget entries for the Nov. 15 budget recommendation.