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Consultants warn Grand Forks County health plan is costly; commissioners ask staff to pursue alternatives
Summary
An outside insurance consultant told the Grand Forks County Commission that the county's benefit‑rich health plan and specialty pharmacy costs have driven loss ratios well above industry targets, prompting commissioners to ask staff to explore funding and plan design alternatives ahead of budget season.
Jeff LeClaire, a managing partner at the Insurance Center/Alair Group, told the Grand Forks County Commission on May 19 that the county’s current fully insured plan is “benefit rich” compared with Midwest benchmarks and is driving higher premiums.
LeClaire said the county’s loss ratios were about 124% in 2024 and 128% in 2025, and that specialty prescription drugs and a small number of very high‑cost claimants are major cost drivers. “Eight people, average age about 50, had 37% of the total paid claims last year,” he said, noting specialty drugs now account for a large share of pharmacy spend.
LeClaire outlined funding options — continue fully insured coverage, move to level‑funded plans, or pursue self‑funding or captive arrangements — and described the tradeoffs. “Fully insured is lowest risk but lowest reward; self‑funded turns into a risk‑and‑reward scenario,” he said. He recommended using actuarial projections and updated claims through July to model possible renewals, noting the formal renewal from Blue Cross is typically not available until September.
Commissioners pressed staff to pursue competitive checks and legal options. Commissioner Bierke said the current trend is “not sustainable” and asked staff to explore additional vendor groups and whether a new plan could be offered to future hires beginning Jan. 1, 2027. LeClaire and county staff agreed to return with deeper analysis in July and market quotes once more claims data are available.
The commission did not adopt any formal change at the May 19 meeting; next steps include staff follow‑up and a deeper review at the July benefits meeting and when renewals are received in the fall.
Ending: The presentation concluded with a unanimous request from several commissioners that staff research options and return with more detailed, costed proposals before final budget decisions.
