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Commission approves Sun Life stop‑loss renewal; premiums expected to rise about 11.8%
Summary
Mount Clemens approved renewal of stop‑loss insurance administered by Sun Life for the July 1, 2025–June 30, 2026 policy year; staff said the city retains the first $80,000 of claims per family unit and aggregate attachment will increase from $2,030,000 to $2,110,000.
The Mount Clemens City Commission authorized renewal of the city’s stop‑loss insurance with Sun Life at its May 5 meeting, a move staff said protects the city from catastrophic medical and prescription drug claims.
City manager Greg Shipman summarized the program and the city’s membership in a group captive (Legend RE, operated with Pareto Health as fronting carrier), explaining the mechanics and recent cost history. “Stop loss premiums are expected to increase 11.8% or approximately $46,700 for the period beginning 07/01/2025 through 06/30/2026,” Shipman said. He described the two parts of stop‑loss coverage: an individual stop‑loss that reimburses the city after a family unit exceeds $80,000 in paid claims, and an aggregate stop‑loss that limits total group exposure; staff noted the aggregate attachment point will move from $2,030,000 to $2,110,000.
Shipman said stop‑loss premiums make up about 22% of the city’s health‑plan expense and described the decision to join the captive in July 2022, which initially reduced premiums for the group. Commissioners asked for clarification about attachment points and the distinction between fixed premium costs and variable aggregate liability before moving the renewal to a vote.
The commission moved and approved the renewal and authorized city officials to execute the necessary documents for the 07/01/2025–06/30/2026 policy year.
