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Seminole County approves 2027 benefit changes, moves to review pharmacy contract and study RFP options
Summary
The Seminole County Board of County Commissioners unanimously approved 2027 plan design changes and proposed employee contribution increases, directed staff to move pharmacy benefits to Cigna's acquisition-cost-plus model for plan year 2027, and asked staff to investigate initiating an RFP for 2028 and return with analysis by November.
The Seminole County Board of County Commissioners voted unanimously to approve staff recommendations for the county's 2027 employee health benefits package, accepting plan design changes, proposed employee contributions and a pharmacy purchase approach staff said will reduce drug spend.
Christina Brandolini, the county's human resources director, presented the plan and introduced consulting support from Alliant. Tim Jeks of the Office of Management and Budget told commissioners the FY27 benefits budget assumed an average 12% increase in premiums and projected roughly $11,000,000 in total reserves. Charles Cook of Alliant reviewed plan-design moves that normalize coinsurance and raise some deductibles to match IRS HSA minimums, and he said the contribution changes have pushed enrollment toward lower-cost plans.
Brandolini and Alliant recommended that the board approve the deductible and out-of-pocket changes for plan year 2027, the proposed monthly employee contribution schedule, and a pharmacy arrangement known as Cigna's acquisition-cost-plus model for plan year 2027. Staff also recommended that Alliant and procurement initiate an RFP for plan year 2028 while the county continues to monitor narrow-network and PBM market changes.
Cook said the Cigna acquisition-cost-plus proposal would reduce projected pharmacy spend by about $852,000 for 2027; modeling that layered patient-assistance programs and international sourcing raised the possible savings range but staff described those as more uncertain. Jeks told the board the county had experienced unusually large high-dollar claims in recent years and that the plan-cost models used conservative assumptions.
Commissioners debated whether to pursue a full RFP or to first perform additional market analysis and negotiations with existing providers. Commissioner Lockhart said he preferred trying to capture efficiencies without launching a full RFP because of the operational disruption and procurement workload; other commissioners asked staff to research alternatives such as piggybacking on existing public-sector contracts.
Commissioner (speaker 12) moved to approve the recommendations with a modification to the fourth bullet directing staff to "investigate initiating" an RFP for 2028; Commissioner (speaker 11) seconded. The motion passed unanimously. Staff said they would return with more detailed analysis and a decision-ready packet by November (October preferred by staff).
The board requested additional detail on dollar impacts of plan changes, the impact of moving employees among plan tiers on plan reserves and the required filings with the Office of Insurance Regulation. Brandolini noted the county will host a financial benefits expo this week with Medicare and Social Security presentations for employees.
The board's action preserves the selected plan-design changes and authorizes staff to proceed with the pharmacy contract change for plan year 2027 while pursuing further market work before a possible full procurement for 2028.
