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Committee approves 2025 health‑plan design changes after hearing on rising claims and premiums
Summary
Facing a preliminary 15.5% renewal estimate and higher claims, the committee voted to adopt plan‑design changes for 2025 (higher deductibles and copays, reduced employer HRA) while keeping general municipal premiums at 0%; administration said final rates will be locked in after October/November stop‑loss quotes.
The Chippewa County executive committee voted to adopt recommended design changes to the county’s 2025 health plan after staff described sharp near‑term increases in medical and stop‑loss estimates.
Toni Pfofelder, the county’s HR presenter, told the committee the county received a preliminary renewal estimate in May equal to 15.5 percent, with claims trending substantially higher year‑over‑year. “Our claims were up by 64.5% from the same time last year,” she said, summarizing why the county needed to consider plan‑design adjustments to avoid adding a premium for most municipal employees.
To close an estimated remaining budget gap of roughly 10 percent (staff estimated about $800,000), the resolution proposes five primary changes to plan design for 2025: raise the individual deductible from $6,000 to $9,000; increase the out‑of‑pocket maximum (individual) to $21,000; reduce the employer health reimbursement account (HRA) deposit (from $600/person, $2,400 family max, to $500/person and $2,000 family max); raise urgent‑care copay from $25 to $75 and emergency‑room copay from $250 to $350; and increase certain prescription copays (tier 2 from $30 to $45 and tier 3 from $60 to $75).
Pfofelder and County Administrator Randy Schultz said staff built 5.5 percent of the estimated increase into department budgets and are recommending the design changes to avoid charging a premium to general municipal employees while maintaining a 4 percent premium for law enforcement in accordance with contract language. Staff noted final stop‑loss and premium rates typically are not locked until October or November, and the resolution includes a reporting deadline: the county administrator will report actual plan costs to the county board no later than Dec. 10, 2024, if costs exceed projections.
Supervisors asked about employee outreach; Pfofelder said staff had circulated educational materials and a video to employees and would continue communications. The committee approved the resolution by voice/virtual vote.
Next steps: staff will continue monthly rate monitoring, finalize stop‑loss quotes in the fall and report back with final premium and plan‑design recommendations as required by the resolution.
