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Ventnor moves to partially self-insure employee health benefits; dedicated account authorized
Summary
The commission authorized a new depository account and a move toward a partially self-insured health benefits program intended to reduce the city’s 2026 premium increase from a projected ~36% under the state plan to about 14% under the new structure, with stop-loss and reinsurance described.
Ventnor City officials on Nov. 13 described and authorized steps to withdraw from the State Health Benefits Plan and establish a partially self-insured program for municipal employee health insurance. Staff said the change will include a dedicated depository account for self-funded claims, administration via a third-party administrator and reinsurance above an aggregate stop‑loss threshold.
A city representative explained that the State Health Benefits Plan had proposed a roughly 36% premium increase for 2026; under the new approach the city expects about a 14% increase instead. Officials said the structure will allow the municipality to capture prescription rebates and gain more direct control over claims management, while retaining reinsurance for catastrophic exposures.
The commission authorized opening the new depository account and authorized staff to execute related health-insurance contracts (including a loss-limit contract with the named carrier in the packet). Officials emphasized that employees will still see a contribution deduction from pay but that the city expects the increase to be lower than it would have been under the state plan. Staff noted the program remains contingent on successful reinsurance placement and administrative arrangements and that the city will receive reports on paid claims and account activity.
