Seward County reviews options as medical premiums rise; no benefit choice finalized

Seward County commissioners met in a March 16, 2026 work session to review health and dental insurance renewal options and financial illustrations as the county prepares for open enrollment.

Nick, an IMA representative, told the board the county—s self-funded medical renewal came in at about a 6.3% increase (roughly $312,000) while dental is projected to drop about 2.9%. He said administrative fees with Blue Cross of Kansas are unchanged but stop-loss premiums are up roughly 35%, a key driver of the renewal—s higher cost. "The self funded renewal came in at a 6.3% overall increase," Nick said, and he noted three years of claims trend produced an additional 2.1% utilization increase.

The presentation laid out several alternatives to the county—s current grandfathered $200 deductible design. One option (labeled Option 5) would raise the deductible to $500, add copays and shift to the tighter Results Rx drug formulary; that change would reduce the projected renewal impact from 6.3% to about 1.2% (an estimated ~$255,000 in savings versus renewing the current plan). Other options (6–9) were $1,500 deductible designs with differing formularies and out-of-pocket caps; staff presented the county could offer dual options so employees could choose a richer low-deductible plan or a higher-deductible option with lower employer cost.

Presenters warned that moving the drug formulary to Results Rx would affect a minority of claims: "94 percent of the claims that have been filled this last plan year wouldn't be affected at all," Nick said, and "about 6 percent of claims would be disrupted." He added that Blue Cross would communicate alternatives so members and their doctors could plan for changes.

The group also reviewed a Freedom Choice medical expense reimbursement plan (MERP) alternative. Under that structure the county would purchase a high-deductible umbrella policy (presenters used a $6,000 umbrella in illustrations) and effectively reimburse claims in the gap between employee out-of-pocket and the umbrella deductible. Freedom representatives Julie and Adley said the MERP raises predictable fixed costs and can limit employer liability in some scenarios but increases employer exposure if many members fall into the middle-cost bucket. "You are shifting your cost," Julie said, summarizing how the MERP changes the stop-loss and reserve dynamics.

Nick walked commissioners through cost and break-even illustrations comparing the Blue Cross ASO renewal and the Freedom MERP. The Blue Cross renewal scenario showed anticipated medical and pharmacy claims around $4.3 million plus fixed stop-loss and admin costs (presented as a renewal total near $5.1 million in the renewal illustration). The Freedom illustrations showed lower expected claims in some scenarios but higher fixed umbrella premiums and a break-even point sensitive to how many members hit the middle-cost band.

The presenters also reviewed three employee-contribution illustrations. One keeps the grandfathered plan and raises employee contributions to the legal maximum; the two dual-option illustrations shift more members to higher deductibles with different employee contribution mixes. Migration between options is uncertain and presenters said the enrollment outcome would materially affect net county costs. Nick noted the group used example migration assumptions (for one illustration he said an estimated 75% might move to the $1,500 option) and described that as a heuristic rather than a precise projection.

Commissioners asked for clarifications on which amounts in the budget are reimbursed and which are net employer cost. Angela read reimbursement figures aloud during the meeting and commissioners requested the underlying spreadsheet to reconcile gross premium lines, reimbursements and net cash out. Presenters emphasized the county must decide soon to meet open-enrollment timing: enrollment ideally needs to start by April 1 for a May 1 effective date.

No formal benefit selection or contract award was made in the work session. The board closed with a motion to adjourn; the motion to adjourn passed 5–0.

The commission directed staff to return with clarified reimbursement totals, finalized contribution options and enrollment schedules so a follow-up meeting or special session can finalize selections before open enrollment begins.