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County says self-insurance fund is stable for now but rising claims and insurer signals prompt RFP and targeted programs
Summary
Auditor staff reported the county started the year with roughly $2.44 million in its self-insurance fund after a $3 million transfer last year. Staff and the new HR director said they will run an RFP for ancillary benefits, hold an enhanced open enrollment, and explore targeted programs for very-high-cost claimants after benefits administrator Apex signaled possible rate increases.
Monroe County officials told the Long-Term Finance Planning Committee that the self-insurance fund is in a stronger position than a year ago but faces uncertainty from a handful of very-high-cost claims and marketplace pressure.
Auditor staff said a $3 million transfer to the self-insurance fund in the prior year left the fund with about $2.44 million at the start of 2026. Staff told the committee they used only a portion of the transfer and that current projections show an end-of-year fund balance in the low millions under several scenarios.
New HR Director Melissa Stinson Wadell said the county will run a competitive RFP for ancillary benefits, hold an open enrollment aimed at encouraging employees to choose cost-effective care options, and pilot targeted programs to manage very-high-cost claimants. Wadell said one program under consideration would involve a one-time expense to remove a claimant from the plan in exchange for covering future medical costs under a different arrangement; she said participation would be voluntary and subject to acceptance. She told the committee the county planned a procurement and employee outreach schedule that could move open enrollment earlier than November if that proves administratively feasible.
Staff noted that Apex, the county's benefits administrator, had flagged a possible premium increase during preliminary discussions; staff described an initial estimate in those conversations near double-digit percentage territory and said they would return with updated May data once available.
Next step: HR and the auditor will complete the ancillary RFP and share program details and enrollment timing with council and employees ahead of budget adoption and open enrollment.
