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Clermont County to move medical plan into cooperative amid projected $800,000 first‑year savings; MetLife dental renewed
Summary
The Clermont County Board of Commissioners voted Sept. 4 to accept a benefits advisory recommendation to shift the county's employee medical plan into a county cooperative (Anthem/SEBCO/SEPCO) and to renew employee dental coverage with MetLife for 2025. Presenters said the change narrows volatility and reduces the county's projected contribution by about $800,000 for the first year.
The Clermont County Board of Commissioners voted Sept. 4 to accept a recommendation from the county's benefits advisory committee to move the county's employee medical plan into a county cooperative arrangement with Anthem and to renew dental coverage with MetLife for calendar year 2025.
Steve Ferguson of benefits consultant USI told the board the county's current self‑insured program carries an estimated 2024 cost of about $15.9 million. Ferguson said Staying with the current vendors (UnitedHealthcare with stop‑loss through Voya and pharmacy manager Magellan) would raise the county's projected contribution to roughly $17.5 million — an increase of about $2.2 million, or 13.5 percent. He said the cooperative option would replace a claims‑based renewal with a more predictable monthly premium and reduce the county contribution to about $15.1 million, a roughly $800,000 first‑year savings: "the savings is about $800,000," Ferguson said during his presentation.
The USI presentation summarized key tradeoffs. Officials said the cooperative reduces month‑to‑month volatility by pooling claims across participating counties and bundles vendor services such as COBRA administration and certain government reporting fees. County staff noted a likely run‑out cost for claims incurred in 2024 and an actuary estimate of about $1.5 million in reserves to cover that runout. The cooperative option as presented would be a three‑year contract with potential exit penalties if the county left early.
The packet and presentation also highlighted benefit design changes: the county currently covers certain GLP weight‑loss medications; the cooperative plan presented would not include coverage for those drugs. Ferguson said the county retains an option to create a separate arrangement to continue GLP coverage for employees if the board chooses to do so.
Board members and staff discussed clinical and cost issues, including future availability of generic versions of certain drugs and adverse effects such as gastrointestinal issues and a risk of pancreatitis. Ferguson said plan design and pharmacy oversight would be important if the board seeks to continue any GLP coverage.
After discussion the board voted unanimously to authorize staff to proceed with the cooperative medical arrangement and to ratify a MetLife dental renewal for 2025. Commissioners directed staff and the benefits coordinator to finalize contract documents and return them for formal ratification.
What happens next: county staff will work with the benefits advisory committee to set employee contribution rates, finalize plan design choices and prepare contract documents for board ratification. The cooperative option is expected to be effective Jan. 1, 2025.
