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Council approves renewal of town health plan reinsurance with higher deductible
Summary
The Flower Mound Town Council approved renewing stop-loss (reinsurance) coverage with Voya, moving to a $185,000 specific deductible and retaining Quantifi Specialty Care for infusion services; staff said the change trims approximately $25,000 from annual fixed costs and addresses high-cost claimants.
The Flower Mound Town Council voted unanimously to renew the town's stop-loss (reinsurance) coverage with incumbent carrier Voya, adopting a $185,000 specific deductible for plan members and retaining Quantifi Specialty Care for high-touch infusion therapies.
Human-resources director Linda Valaito presented the recommendation, saying the deductible change "made the most sense" after the town's request for proposals produced three offers and yielded a 1.17% decrease in premium, approximately $25,000 in annual fixed-cost reduction. She told council the change would take effect Jan. 1, 2026.
Sandy Brown, the McGriff vice president who presented the stop-loss analysis, explained the structure of the recommended plan and how carriers treat "lasering": "The $185,000 deductible is on all members. There are four lasered individuals who will have a $1,000,000 specific deductible each," she said, describing that practice of assigning higher deductibles to known high-cost claimants.
Council members pressed staff on why only three carriers responded to the RFP of 17 solicited and questioned the plan's exposure to high-cost pharmaceutical therapies. Brown and Valaito said the town's loss ratio has exceeded 100% most years since 2019, making the market less willing to quote, and that Quantifi Specialty Care helps manage some rare-condition infusion costs and member care coordination.
Council discussion emphasized the challenge of rising health-care costs. One member summarized the issue: "We're looking at health-care costs where somebody comes with some crazy drug and says I'm going to charge you $100,000 a month," and urged continued efforts to control long-term trends. Presenters said preventive programs and specialty-care management have produced better outcomes in other areas of the plan.
The motion to approve the renewal, including the $185,000 specific deductible and continued use of Quantifi Specialty Care, passed by unanimous roll-call vote.
The renewal will proceed with contract execution; staff said they will finalize contracts and implement the change for the 01/01/2026 effective date.
