Get Full Government Meeting Transcripts, Videos, & Alerts Forever!
Get email alerts on the Employee Benefits topic
No spam. Unsubscribe anytime.
County sees rising claims and a possible double‑digit rate increase; benefits consultant urges early planning
Summary
A mid‑year health plan review showed an elevated medical loss ratio year‑to‑date and rising pharmacy and high claims; consultant projected a potential ~10.5% renewal increase and asked whether Avera could offer a two‑year rate guarantee.
A benefits consultant gave a six‑month review of the county employee health plan and warned that pharmacy costs and a few high claims have pushed the year‑to‑date loss ratio well above last year’s level. The consultant said the county’s medical loss ratio was 63.36% for 2025, but reported '154%' for an internal year‑to‑date metric in 2026; he noted high‑cost individual claims and elevated pharmacy spending as the primary drivers.
The consultant said the county’s paid premium versus claims for January–June were nearly even and estimated a potential 10–10.5% premium increase at renewal. Commissioners asked whether the insurer (Avera) would offer a two‑year guarantee and discussed plan‑tier options (including an employee plus one tier) and wellness programs to mitigate costs. Staff will follow up with the carrier and return with renewal details ahead of the October deadline.
No final premium decision was made at the meeting; commissioners were advised to include projected increases in departmental budgets.
