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Consultant tells Jefferson County council self‑insured health plan has produced savings but carries tail‑risk
Summary
A consultant from 1Digital reviewed more than a decade of Jefferson County’s partially self‑insured health plan, saying the arrangement captured surplus previously taken as carrier profit while warning of low‑probability, high‑cost claim years.
A consultant identified as George, representing 1Digital, gave the Jefferson County Council a year‑by‑year review of the county’s partially self‑insured health plan and recommended continued monitoring. He said the county moved from guaranteed‑cost plans to a partially self‑insured model (with a $125,000 specific‑claim threshold) that kept surplus in the county rather than as carrier profit.
George told the council the plan has produced budget benefits and enhanced employee benefits while keeping employee premiums largely flat. He noted the plan is designed to absorb a small number of very large claims — "a hockey stick" distribution — and cautioned the council that roughly once every decade the county may experience a high‑cost year and should maintain surplus for that possibility.
Council members asked whether family coverage could be expanded. George said the family tier currently drives claims and the county has discussed incentives to shift spouses to alternate employer coverage where available, but no change has been adopted.
The presentation included multi‑year charts of claims and premium equivalents; George emphasized regular review and actuarial oversight. Council asked no formal motion or vote on insurance policy during the meeting; the consultant’s analysis is entered into the record for follow up and budget planning.
