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Council reviews six‑month health‑insurance renewal as premiums rise; officials flag impacts of prescription changes
Summary
City staff proposed a six‑month renewal (July 1–Dec. 31) to realign plan years, reporting a 5.65% increase for that period (about $85,000) and changes including moving copay administration from Zurich back to Blue Cross, raising the underlying deductible, and altering prescription copays; council members expressed concern for employees facing higher take‑home‑pay reductions and for those on high‑cost specialty drugs.
At the May 5 study session, Kevin Kashinsky of the Tennessee Municipal League Employee Benefits Program presented a proposed six‑month renewal of the city’s employee health plan that would run July 1 through Dec. 31 to transition to calendar‑year renewals. Staff reported an approximate 5.65% increase for that six‑month period, which the presentation said equates to roughly an $85,000 additional cost for July–December.
Kashinsky described plan design changes negotiated to reduce the large Blue Cross requested increase, including consolidating all agencies into a single pool, moving administration of co‑pays back to Blue Cross, and raising the Blue Cross underlying deductible to $10,600 while relying on Zurich secondary coverage for major medical claims. He said those changes lowered the negotiated rate from the initial 29% proposed increase down to the lower figure presented to council.
Prescription co‑pay structure will change from the prior flat amounts to tiered cost‑sharing (examples given in the presentation included new tiers such as $50/$100 and 30% for specialty drugs). Councilmembers repeatedly pressed staff about the impact on lower‑paid city workers, noting examples such as a roughly $25 per week payroll change for some employees under some options. Several members and staff flagged GLP‑1‑class drugs and other specialty therapies as potential cost drivers and discussed using benefit counselors, manufacturer assistance programs, or one‑off council exceptions for cases with severe hardship.
Staff did not request final action at the study session but sought direction; they recommended additional review and communication with employees and the benefits committee prior to adopting a renewal plan.
