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Kings County approves 14.96% health‑insurance renewal after board questions about large claim and pharmacy rebates
Summary
Kings County’s Board of Supervisors voted to approve a 14.96% renewal for the county’s self‑insured health plan for fiscal 2026–27 after the health‑insurance advisory committee and brokers negotiated the rate down from an initial 21.4% proposal; staff and brokers said a single very large claim and stop‑loss carrier repricing drove much of the increase.
The Kings County Board of Supervisors on April 28 approved a 14.96% renewal for the county’s self‑insured health insurance plan for fiscal year 2026–27, following a presentation from county staff and broker representatives.
Sarah Poots, risk manager for the county, told the board the health insurance advisory committee reviewed renewal proposals in April and recommended the 14.96% option after brokers significantly reduced an initial 21.4% renewal offer. Poots said the committee also recommended keeping the existing stop‑loss deductible and vision network unchanged.
Leroy Tucker of the Baldwin Group, the county’s broker, said the higher renewal followed “a high year in your self‑insured claims.” He told supervisors the broker team audited claims, negotiated stop‑loss and administrative costs and sought competitive bids to bring the rate down from the early 21% estimate to the committee’s recommended figure.
In response to questions from board members, staff and brokers identified a single very large medical claim late in the prior year as a major driver of the stop‑loss carrier’s repricing. As one staff member explained, the stop‑loss carrier “said, ‘Wait, that’s more than the county is paying us in premium, so we need to dig ourselves out of this hole,’” and carriers declined to quote more favorable bids because the county’s stop‑loss premium was below the national average for that deductible.
Board members pressed staff about options to limit future increases: negotiating provider network arrangements, pharmacy‑benefit management, use of reserves, and adding or changing plan designs. Brokers noted the county’s pharmacy rebates—processed by the county’s PBM—have historically offset pharmacy spend and helped dampen net cost trends.
A public commenter representing county employees, Mike Cassenza of COIA, urged the board to use fund reserves to soften the impact on low‑paid employees, calling 14.96% “one of the single highest increases this plan has ever seen” and warning the increase will meaningfully reduce take‑home pay for some workers. Cassenza asked the board to consider applying fund balances to reduce the employee portion of the renewal.
After discussion and the public comment period, the board voted to approve the renewal and the continuation of a $50 wellness blood‑draw incentive for eligible employees and dependents.
What’s next: Staff said they will continue exploring other plan structures and cost‑saving strategies with the Baldwin Group ahead of future renewals, including further analysis of pharmacy trends and alternative plan designs.
