Brown County commissioners voted to discontinue a county-funded supplemental "gap" benefit for 2026 but agreed to cover employees who had qualifying procedures in 2025 if the insurer's Explanation of Benefits (EOB) is received by March 31, 2026.

A commissioner said the county made the decision to forego gap coverage next year to reduce an estimated potential liability (board members cited figures near $79,000 to $85,000 as the historical estimate used during budgeting). After consulting county legal counsel, commissioners concluded they have the authority to extend limited coverage for claims tied to 2025 procedures when paperwork delays by insurers prevent timely processing.

"We have the right to do this," a commissioner said, describing the attorney's review. Commissioners asked staff to compile lists of affected employees, determine total amounts owed in each case and make employees whole for 2025 claims where required EOBs are received by the March 31 deadline. The motion to extend coverage for 2025 procedures and terminate routine gap payments going forward was moved, seconded and carried by voice vote.

County staff explained there is no separate segregated "gap" pot of funds sitting idle; gap payments are handled through the employee-benefits budget line and estimated amounts were used in preparing the 2026 budget. Commissioners directed staff to document the employee list, calculate precise exposures for each 2025 case and report back with numbers for payment processing and bookkeeping adjustments.

The board emphasized the distinction between discretionary future benefits and contracted or accrued liabilities for prior periods and signaled they would cover employee impacts tied to the 2025 coverage year where paperwork delays prevented normal processing.

Next steps: staff will compile affected cases, coordinate with the county insurance broker and process payments for validated 2025 claims with EOBs filed by March 31, 2026. The gap program will not be reauthorized for new procedures performed in 2026.