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Dubuque County supervisors direct committee to share $484,000 health insurance renewal; employees likely to absorb half
Summary
County staff told the Board of Supervisors a 6.6% health-insurance renewal would add about $484,000 to FY27 costs. The board signaled it wants the employee health-insurance committee to identify options that shift roughly half the cost to employees while moderating county risk.
Dubuque County supervisors were briefed on a proposed 6.6% renewal for the county's fully insured health plan that would increase the program's cost by about $484,000 in fiscal year 2027, and signaled they want employees to take on roughly half of that increase.
Sarah Dickinson, a Cottingham & Butler consultant presenting the health plan renewal, said the Iowa Community Trust's renewal came in at 7.8% and "that shakes out to be about a $484,000 increase, and about 6.6% of total spend." She said the county's loss ratio through December is running "at about 96%," meaning claims are using most premium dollars.
The presentation laid out six broad options to reduce the county's share of the increase: raising the plan deductible (for example from $7,900 to $10,000, which Dickinson estimated could save about $70,000), modest increases to employee deductibles, a small increase in office visit copays, higher specialty visit copays (which the committee did not favor), a rise in the employee's percentage contribution (from 8% to 8.5%, roughly $40,000), and restructuring employee contributions into three tiers to collect more from family/spouse coverage (estimated roughly $123,000 impact to the family tier). Dickinson emphasized the figures are estimates based on historical claims.
Supervisor Anne questioned shifting more risk to the county and asked how Dubuque compares with other public employers. Dickinson said the county's plan is relatively "rich" in family coverage and that prior analyses had considered but rejected full self-funding for a group this size because of potential volatility.
"I am not interested in increasing the county's risk exposure," Supervisor Anne said of the option to raise the plan deductible to $10,000, calling that particular choice a "nonstarter." Several supervisors said they would prefer a mix of options 2, 5 and 6 (modest deductible and contribution changes plus a three-tier contribution structure) instead of transferring more risk to the county.
On the question of who should shoulder the renewal, several supervisors asked the employee health-insurance committee to return a recommendation that would have employees absorb about half of the projected increase, with the county covering the remainder. The board did not take a formal vote on any specific change during the session.
Next steps: staff and the health-insurance committee will refine options and return to the board with more detailed budget impacts; the supervisors scheduled further budget work time at the end of the month.
Quotes in this article are taken verbatim from the board's January 29 budget work session.
