Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Employee Benefits topic
No spam. Unsubscribe anytime.
Benefits broker outlines captive, stop‑loss and pharmacy strategies ahead of April renewal
Summary
USI representatives briefed the commission on the county’s self‑funded health plan, explaining stop‑loss trends, captive arrangements, an allied advocate negotiation program for large claims and pharmacy options that they estimate could reduce county spend by roughly $170,000 in an alternative scenario.
Representatives from USI presented options to Linn County commissioners for managing the county’s self‑funded employee health plan ahead of this year’s renewal.
USI staff (including Amy Schroeder, Kansas operations manager) explained national stop‑loss renewal pressures and offered a captive arrangement as one mechanism to stabilize renewals. They described an “Allied Advocate” program that negotiates large claims down toward Medicare‑level payments in certain categories (inpatient, dialysis, large outpatient charges, ambulance) and an allied negotiation example that showed substantial savings in one case.
USI also highlighted pharmacy as a major cost driver, especially specialty medications. They proposed pharmacy‑specific strategies including use of biosimilars and access to manufacturer patient assistance programs that could reduce the county’s pharmacy spend; presenters said four specialty drugs on the county plan accounted for a large share of recent pharmacy dollars and that those costs might be substantially mitigated through manufacturer assistance and better PBM arrangements.
USI indicated they will have renewal numbers in April and recommended beginning marketing and analysis now; commissioners asked whether changing network partners would disrupt employees’ access to care and were told networks are highly similar regionally and that USI would provide provider‑network links for verification before any change.
No procurement decision was made at the meeting; commissioners agreed to review USI’s materials and to receive renewal options in April.
