Marion council hears pitch from HOPE Trust to rein in rising city health‑insurance costs

Alex Steniker, an administrator with Steniker Grama Management, told the Marion City Council on Thursday that HOPE Trust (Health Options for Public Entities) is an intergovernmental cooperative that can help local governments slow the growth of health‑insurance costs.

"There is absolutely no magic bullet with any carrier to come in here and offer us cheaper premiums," the meeting chair said in opening remarks, explaining the council’s concern that rising claims threaten the city’s ability to continue funding current benefits. The chair characterized current trends as "wholly unsustainable" and urged the city to explore strategies to contain claims growth.

Steniker told council members the HOPE Trust was founded about 15 years ago by a small group of counties and now covers more than 5,000 employees and their families. He said the trust has three times returned dividends to members and that, on average, members have seen roughly 3–4% annual increases compared with the larger market’s double‑digit spikes.

"We started seeing escalating costs in the late 2017–2018 period," Steniker said. He described the Trust’s approach as building a custom, proprietary network and tiering providers so that preferred (tier‑1) clinicians and hospitals produce far lower out‑of‑pocket costs for members and more stable reimbursements for payers.

Steniker described several member services the trust provides: an in‑house clinical team to help navigate care and prior authorizations; a customer‑service unit for claims questions; telemedicine (MD Live); and a Health Reimbursement Plan (HRP) option that the Trust estimates 15–25% of employees in participating groups choose when offered. He said those features, together with negotiated network pricing and stop‑loss protection, are how the trust mitigates large claims and reduces year‑to‑year volatility.

Council members pressed the presenters on several practical concerns: whether local systems such as SIH and Deaconess would remain in network, how the trust prices reimbursements (Steniker said the Trust often benchmarks to Medicare rates or multiples), and how Marion’s historically high claims would affect partner counties and pooled risk. Steniker said mergers sometimes occur but contracts generally carry over and that the Trust evaluates each applicant group individually.

One council member expressed skepticism about switching from the city’s incumbent carrier and noted the practical anxiety employees feel at the prospect of change. Steniker and council leaders agreed the Trust’s benefits should be explained through department‑level and bargaining‑unit briefings and recommended use of the Trust’s field team to meet one‑on‑one with employees.

The meeting produced no formal decision. Staff told the council any change would have to be decided well before Dec. 31 to allow a four‑ to five‑month implementation runway; council members requested follow‑up meetings to review proposed premiums, plan options and the HRP mechanics before taking action.

The meeting adjourned after a motion to close the special session passed on roll call.