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Commission hears health‑insurance renewal briefing; consultants recommend switching PBM, commissioners ask for vendor checks
Summary
Gallagher and county staff briefed the commission on health‑insurance renewal challenges, including claims cleanup after an administrator failure and problems with the current pharmacy benefit manager (MedImpact). Gallagher recommended considering Oriad (pharmacist‑run PBM) and the commission asked staff to contact current Edison and Oriad clients and to schedule a vendor presentation before any change.
County staff, joined by Gallagher insurance consultants, updated the Coffey County Commission on the status of the county’s self‑funded health plan ahead of the renewal cycle. The briefing noted significant claims cleanup tied to a third‑party administrator bankruptcy and ongoing operational issues with the county’s pharmacy benefit manager (MedImpact).
Gallagher reported that Oriad — a pharmacist‑run PBM the consultants recommended — offers a 100% pass‑through model and quoted an $8 per‑script administrative price in discussion. Staff warned that switching the prescription administration could require cleanup work and that some hanging claims remain to be resolved. The county’s stop‑loss carrier is also up for renewal and the commission was told the stop‑loss renewal could reflect a 30–38% increase because of recent high claims.
Commissioners asked staff to contact other agencies that use Oriad and Edison to get user feedback and requested a Zoom presentation from Oriad so commissioners and department heads could ask questions. Gallagher and county staff said they would reach out to reference customers and bring additional information back next week; the commission deferred any immediate vendor decision.
The commission also discussed whether to retain a three‑tier deductible structure or collapse tiers, and asked staff to provide utilization numbers for each tier. Open enrollment dates were tentatively set for early May pending a final vendor decision. No contractual changes were voted on at this meeting.
