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County health plan ran slightly above expectations; consultants propose PBM review and network changes
Summary
Presenters told the LaSalle County Insurance Committee the county's health plan ran at about 106.3% of expected with a Blue Cross per-capita cost of $25,091; consultants recommended a PBM RFP, analysis of network options and other cost-containment measures, and the committee voted to accept the report.
Beth, the county's underwriter/analyst, reviewed 2025 year-end plan performance and market context, saying the county's active plan finished the year at about 106.3% of expected and reporting a per-capita cost of $25,091 on the Blue Cross plan. "You ended the year at a per cap of 25,091 on the Blue Cross plan," Beth told the committee.
Beth and the consulting team traced much of the recent volatility to large claimants and market changes in Medicare Advantage and specialty drugs. She noted the county's pharmacy share is lower than national benchmarks because inpatient and outpatient costs make up a larger…
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