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1to1 clinics report high satisfaction; committee to reassess stop-loss self-funding after a $500,000+ claim
Summary
1to1 Health reported high patient satisfaction and utilization numbers; ESP and committee flagged one member exceeding the $500,000 stop-loss threshold and agreed to revisit whether to continue self-funding or buy an external stop-loss policy.
Kelly Ballinger of 1to1 Health (Speaker 3) presented year-end and January metrics showing strong utilization and patient satisfaction: the Sumner Shaffer clinic had the highest volume, the plan-wide patient-satisfaction score was 98.5%, engagement ended the year at 72.3%, and clinic services totaled 1,469 for the plan year. Ballinger said the Portland clinic saw 926 county visits in 2026 (county-only figure) and that the Board of Education will separately provide school counts.
ESP representative (Speaker 5) reviewed the county’s stop-loss approach: the county has been self-funding stop-loss and maintains a running stop-loss fund (about $1.3 million in cumulative reserves). This year one member’s claims have exceeded the $500,000 specific-stop-loss threshold by approximately $19,000. Speaker 5 recommended monitoring the claim and presenting precise numbers to determine whether to draw on the local stop-loss reserve or purchase third-party stop-loss coverage in future years.
Chair (Speaker 1) moved to place the stop-loss funding review on old business and asked ESP to present the detailed calculations, historical payouts and a recommendation on whether to continue self-funding or buy external stop-loss coverage. The motion passed by voice vote.
Next steps: ESP will return with a full presentation including historical ten-year payout data, current census, specific member claims over threshold and recommended trigger levels for bringing stop-loss fund draws back to the committee.
