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MAKO tells Fallon County commissioners pooled trust could expand plan options; commissioners ask for rates and transition timing
Summary
Representatives from the Montana Association of Counties presented health‑trust plan designs, stop‑loss pooling mechanics, pharmacy savings and administrative services; the commission asked for rate numbers, timing options and how the county’s retirees and hospital could be accommodated.
Representatives from the Montana Association of Counties (MAKO) briefed Fallon County commissioners and staff on the health trust’s medical, dental and vision plan options and the services the trust provides to counties.
MAKO representatives said the trust offers multiple medical plan designs including high‑deductible HSA options, plans that waive deductibles for certain services, and administrative support such as COBRA, PCORI and 1094/1095 reporting. They described pooled stop‑loss protection (the trust pools catastrophic claims above a $50,000 threshold) and an actuary‑driven annual pricing model that blends a two‑year trend and applies county‑level adjustments (up to 10% below or 5% above the trust average depending on claims experience).
Speakers emphasized network strength (Allegiance/Cigna) and said recent PBM changes yielded pharmacy cost savings. MAKO said the trust provides hands‑on enrollment support and employer‑facing services that some smaller counties lack locally. Commissioners asked whether hospital partners could remain on the county plan; MAKO said nonprofit hospitals may participate but employer contributions can differ between the county and other employers.
MAKO representatives also explained contract timing: counties join on a fiscal‑year schedule, with an initial three‑year commitment and an annual opt‑out deadline (March 1) thereafter. Several commissioners requested written rate quotes and a comparison matrix; MAKO agreed to provide supporting documentation and follow up with detailed numbers.
Next steps: MAKO will supply rate scenarios, plan comparisons and transition options for the commission to review before making any formal action.
