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Consultant urges Benton County to split insurance tiers, recommends 6.1% funding increase
Summary
A McGriff consultant told the quorum court the county should move from three to five benefit tiers (separating spouse and child coverage), fold a spousal surcharge into payroll deductions and maintain a 6.1% funding increase to keep the self‑insured plan adequately funded.
A consultant working with the county presented changes to employee health benefits Tuesday that would separate spouses and children into distinct tiers, embed the current spousal surcharge into payroll deductions and keep the county's health‑plan funding at about 6.1% higher next year.
The presenter said the current three‑tier structure—employee only, employee plus one and employee plus two or more—masks differences in risk between spouses and children and recommended five tiers so premiums better reflect who is covered. "The market norm is to have an employee‑spouse category and an employee‑child category," the presenter said, arguing the change would align premiums with the underlying claims risk.
The consultant explained the county currently charges a spousal surcharge of roughly $100 a month (about $50 per pay period) and proposed embedding that amount into the standard deductions for spouse and family coverage so the surcharge would no longer be a separate administrative line item. "We're just taking that $50 and getting rid of the surcharge, and we're putting it into that deduction cost," the presenter said.
On overall funding, the presenter recommended holding the county's contribution at the 6.1% increase previously proposed by county staff. "With updated numbers through August, we ran the numbers and that 6.1 is still adequate to meet the funding needs of the county," the presenter said.
Several justices asked how changes would affect employees. One justice raised the concern that employees in certain tiers could see higher payroll deductions, particularly if an employee's dependent mix shifts from child to spouse coverage. The presenter replied that the change would be revenue‑neutral for employees currently paying the spousal surcharge but would provide better visibility into where claims cost is coming from and allow the county to analyze utilization and target cost‑control measures.
The consultant and several members also discussed prescription drug cost uncertainty, noting state PBM litigation and pending federal actions could change pharmacy spending but that there is not yet reliable data to adjust rates. "My hope is that prescription drug cost will go down in the near future, but I can't sit here with a clean conscience and say, yes, they will go down," the presenter said.
Next steps: the presenter invited further questions and proposed the county proceed with the five‑tier structure and the 6.1% funding assumption while monitoring utilization data during open enrollment.
Ending: The court did not take a formal vote on the benefit design at Tuesday's meeting; the presentation will inform final budget and plan‑sponsor decisions this fall.
