Micah Bollinger, the countys insurance presenter, told the Montgomery County Board of Commissioners that its self‑funded health plan has seen a sharp rise in high‑cost inpatient claims this plan year. "We're up about a half a $1,000,000 from last year at the same time period to this year," he said, attributing most of the increase to eight large claims and higher inpatient stays.

Bollinger showed commissioners plan-year numbers through November 2024 that put total paid claims near $2 million versus $1.55 million last year in the same period and said inpatient hospital charges rose from approximately $29,000 to about $296,000. He added that five of the eight largest claims had exceeded the plans stop‑loss deductible and were being reimbursed: "Most of the large claims ... have exceeded our stop loss," he said, noting the stop‑loss reimbursements will help offset some of the spike.

Why it matters: the countys health plan is self‑insured, meaning large claims can materially affect county finances and employer contribution rates. Bollinger said key drivers include inpatient admissions and a handful of high‑cost episodes, often cardiac or surgical, that required care outside the countys preferred low‑cost providers.

Recommendations and next steps: Bollinger proposed an early‑January series of work sessions to analyze renewal options and vendor bids and to consider structural changes for plan risk. He said he is exploring group‑Medicare options and incentives for employees age 65 and older: "We're gonna do 2 Medicare seminars ... the 2nd or 3rd week in January and the 2nd week of February," he said, proposing education and incentives to encourage appropriate enrollment choices. He also recommended evaluating reference‑based pricing and pursuing better contract terms with high‑cost providers.

Pharmacy and other cost controls: Bollinger reported pharmacy spend was down and that script sourcing (outsourcing certain specialty drugs) produced a 61–63% savings where used. He also noted that prescription rebates and stop‑loss reimbursements are expected to reduce the plans net cost. Still, he urged the board to prepare for an overall plan-year spend the county might see in the $2.9M–$3.2M range if current trends hold.

Board reaction and timeline: Commissioners asked for more granular data and requested follow‑up meetings and vendor interviews in January to weigh the trade‑offs of any aggressive cost‑control strategies. Bollinger said he will return with renewal quotes and deeper analyses of high‑cost claim events and provider network leakage.

The board did not take action on policy changes at the meeting; Bollinger recommended a set of work sessions and vendor briefings early next year to finalize any plan design or vendor shifts.