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Caller briefs committee on county health-plan costs; RXMapper shows early savings for a few participants
Summary
Karen McGregor told the committee that the county's plan is running a roughly 97.5% loss ratio and that RXMapper participation by six qualifying employees projects about $62,000 in annualized savings, while migration from Ease to Employee Navigator is estimated at $2,000–$5,000.
Karen McGregor, calling into the meeting, reviewed Stephenson County’s employee-benefits picture and prescription-cost pilot results.
McGregor said the county’s 12-month rolling data show total premiums of about $4.4 million and total claims of about $4.3 million, “so we’re running at about a 97.5% loss ratio,” and she emphasized that a small number of high-cost specialty-drug claimants drive a large share of drug spending. She flagged two large work-comp claims: a tree-cutting accident listed at about $60,000 and a slip-and-fall on ice listed at about $80,000, and noted auto physical damages tied to a sheriff’s vehicle collision and a recent hail storm.
On benefits administration, McGregor said the county currently uses Ease and that Employee Navigator acquired Ease. She said staff will recommend migrating to Employee Navigator for the upcoming open enrollment; the migration cost estimate provided to the committee ranged from about $2,000 to $5,000.
McGregor described RXMapper, a prescription-DNA sequencing program the county began using. She said the board increased approved participation to 10 people; eight employees had responded to outreach and six met the program’s criteria. Of those six, five completed sequencing and analysis and were receiving recommendations; McGregor stated projected annualized drug and medical savings for those six participants of about $62,000 while RXMapper had invoiced the county $6,100 to date.
Committee members asked about incentives and outreach to increase participation. McGregor suggested department-head presentations and ongoing targeted communications, and said the program is intended for employees with chronic conditions or those taking specialty drugs rather than for broad universal enrollment.
McGregor offered to send materials to department heads and to follow up with additional outreach to increase eligible enrollment.
