Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Employee Benefits topic
No spam. Unsubscribe anytime.
Union County moves to two-plan system and tighter cost-sharing after $5–7M claims shortfall
Summary
County manager said a prior administrator underreported claims and the self-insured fund faces a $5–7 million shortfall; the county will offer a lower-cost core plan and a buy‑up plan, raise deductibles and out-of-pocket limits, add co-pays, and restrict GLP‑1 coverage except for diabetes to reduce future deficits.
Union County officials told commissioners May 4 they will change the county’s self-insured employee health plans and increase member cost-sharing to address a multi‑million-dollar shortfall in the health fund.
County Manager Brian Matthews said an audit of the prior plan administrator revealed previously unreported claim liabilities, leaving the county $5–7 million behind on claims the county must pay. “By the time we got in and figured out what was going on, we were five or $6 million in the hole for claims that we did not budget for,” Matthews said.
To address the shortfall, the county has established two plan tiers for FY2027: a core plan with benefit structure closer to the previous plan but higher deductibles and out-of-pocket limits, and a buy-up plan that more closely resembles the current plan but carries higher employee premiums. The county also added co-pays for office visits to help members predict costs and removed coverage for GLP‑1 weight-loss drugs except when prescribed specifically for diabetes treatment, citing unsustainable plan spending on those drugs.
Matthews and staff said they attempted to split recovery between higher premiums and increased member cost-sharing rather than shifting the full shortfall to premiums. The county has replenished the health fund with $7.5 million to cover immediate liabilities; Matthews warned the board that further adjustments could be necessary next year depending on future claims.
Staff emphasized that Blue Cross Blue Shield networks, voluntary benefits and dental plans are unchanged, and that an employer clinic remains available for employees and covered dependents. The county is in an active open‑enrollment period through May 29 to allow employees to select plans and flex‑spending options.
