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Clermont County adopts 2025 employee health coverage and considers a third, lower-cost plan
Summary
The board approved employee medical and prescription coverage for 2025, implementing SEBCO/Anthem plans and adding a third "value" co-pay option recommended by the Healthcare Advisory Committee and HR to reduce county premium growth and lower some employee payroll costs. Commissioners also discussed GLP-1 (weight-loss) drug coverage and vendor outsourcing options.
The Clermont County Board of Commissioners approved a resolution to implement employee medical and prescription coverage for calendar year 2025 as presented by USI benefits consultant Steve and Yvonne Smith of the county human resources office. The action added three medical plan options tied to the county's move to SEBCO/Anthem and established per-pay employee costs for the cafeteria plan.
USI explained that adding a third "value" co-pay plan would reduce the county's expected increase from 8.5% (two-plan option) to about 7.8% and yield approximately $100,000 in county cost savings. The third plan maintains co-pay structures that keep most routine doctor visits and prescriptions within co-pay levels so employees who do not hit high deductibles could see lower weekly payroll deductions (an example figure provided was $20 per month for the basic co-pay tier).
The consultants also addressed GLP-1 (weight-loss) drugs, reporting SEBCO would not continue covering GLP-1s for weight loss in 2025 but that those medications remain covered when prescribed for diabetes. Presenters said the county spent about $65,000 so far for 26 members in 2024, noting manufacturers' coupons had limited county outlays. Outsourcing access to GLP-1s through a vendor was discussed as an option but was recommended against by HR and the healthcare advisory committee for 2025 because projected costs could exceed $500,000.
Board members raised questions about how quickly GLP-1 prices could fall if generics enter the market and whether that would allow Anthem/SEBCO to resume coverage. Presenters said plans exist to review options if cost or availability changes in future years.
After discussion, the board added the benefits resolution to the meeting agenda and approved it on roll call. The record shows the board accepted the Healthcare Advisory Committee and HR recommendation to add the third plan and to implement 2025 employee per-pay costs with no increase to employees under the recommended scenario.
Next steps identified in the meeting include finalizing plan documents, communicating employee elections and payroll deductions, and implementing the new effective-date provision for new hires (coverage effective the first day of the month following 30 days of employment).
