Commissioners hear health-insurance review; staff to vet alternative pharmacy manager

County staff, with consultant support from Gallagher, briefed the Coffey County Commission on the health-insurance renewal and lingering claims-processing issues from 2024–25.

Staff said the county’s self-funded evaluation shows ongoing cleanup of medical and pharmacy claims and identified problems with the current pharmacy benefit manager, MedImpact. The consultant recommendation, as described to the board, was to consider switching the pharmacy component to Oriad. Staff relayed Oriad’s pitch that it offers "100% pass through" of rebates and an $8-per-prescription administrative figure; Gallagher and Edison (the third-party administrator referenced) reportedly support further evaluation.

Commissioners discussed potential operational headaches involved in switching vendors and asked staff to contact existing Oriad and Edison customers for references. Staff agreed to arrange a Zoom presentation with Oriad and to return with more comparative cost and usage data next week before any contract change is made. Staff also noted potential rate pressure from the stop-loss carrier after several large claims; estimated increases in stop-loss costs of 30–38% were discussed and staff will obtain more detailed quotes.

The board discussed keeping the three-tier plan design (deductible options at $1,000, $1,500 and a high-deductible plan) versus simplifying to two tiers; staff will provide enrollment counts by tier to inform that decision.

Next steps: staff will contact reference customers for Oriad and Edison, schedule a vendor Zoom presentation, gather stop-loss quotes and return with updated cost and enrollment information at the next meeting.