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Mako presenters tell Daniels County to expect single-digit insurance increases; trustees moved to smooth spikes
Summary
Representatives from the Property & Casualty Trust and the Joint Powers (healthcare) Trust told Daniels County commissioners on April 20 that pooled insurance reserves and an actuarially driven price correction will likely produce a roughly 7–9% premium increase at renewal, with options for plan design and participation thresholds. County officials pressed for clarity on deductibles, pharmacy costs and how trustees use reserves to smooth large market swings.
Representatives from Mako, which administers both the county’s property-casualty pool and the Joint Powers healthcare trust, presented renewal quotes and pool performance data to Daniels County commissioners on April 20. The presenters said overall market pressure and higher insured values will push the county’s combined premiums up modestly at the July 1 renewal.
Jason Riddle and Eric Bryson of Mako described how the property-casualty trust uses a pooled model to share large claims among member counties while building reserves to smooth future rate shocks. They said the trust uses an independent actuary and targets a capital reserve to avoid abrupt spikes in member premiums; when trustees have chosen to “buy down” actuarial increases in the past, that has moderated near-term rates but left less cushion for later years.
For the healthcare side, Mako’s Pam Wallally and colleagues reviewed plan options and sample premiums based on the county’s employee census. The quote package included a lower-deductible plan (example: $500 deductible with $1,500 max out-of-pocket) and higher-deductible alternatives. Presenters emphasized prescription drug costs as a major driver and noted that some specialty medications can move a plan’s claims dramatically; they urged counties to consider 90‑day fills and pharmacy strategies to reduce per-fill dispensing fees.
Commissioners pressed presenters on three points: how trustees decide when to spend reserves to buy down rates, the 75% participation threshold the trust verifies for eligibility, and how design choices affect employees’ out‑of‑pocket exposure. Riddle said trustees have revised their approach since earlier years when repeated buy‑downs left the trust vulnerable to a later jump, and that current policy is to smooth increases rather than set rates to zero.
The presenters also described the trust’s pooling point (claims above the county-level corridor are shared) and provided examples of how single large losses have been handled in the past, including reinsurance and subrogation attempts. They recommended that the county compare the quoted plans side‑by‑side with current pharmacy pricing and consider administrative steps to encourage 90‑day fills and other cost-saving behavior among employees.
Next steps: Mako will provide the county’s final renewal numbers for commissioners to review at a special meeting, and staff said they will schedule a vote on whether to enroll with the presented plan design and final premium at the county’s upcoming signing meeting.
