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Council accepts small health‑insurance amendment after review of waivers and stop‑loss
Summary
West Orange finance staff presented a modified health‑insurance worksheet that reduced the introduced ask by $15,956 and clarified waiver payouts and stop‑loss arrangements; council approved the amended page unanimously.
Finance staff walked the council through a modified health‑insurance ask that reduced the introduced amount from $17,008,000 to $16,992,000, a savings of $15,956. Staff explained the town moved its active prescription coverage to a self‑insured model in April to capture rebates and better align premiums with claims.
The CFO noted a plan to monitor out‑of‑pocket maximums and stop‑loss thresholds for both medical and prescription claims. He also provided a detailed breakdown of employee waivers: total annual waiver payments for 2026 are $345,000, with the post‑2010 $5,000 maximum portion totaling about $242,000 and legacy, pre‑2010 50% payments totaling about $103,000.
Councilors pressed for more information about large individual waiver payouts and IRMAA reimbursements for retirees. The CFO said the largest IRMAA impact is driven by a few high‑dollar retirees and that he did not have a precise IRMAA sub‑report on hand.
Council voted to adopt the amended health‑insurance page. The administration said it will continue evaluating plan design, including the decision to remain self‑insured for prescriptions and the opportunity to shop alternative brokers or pooled arrangements for further savings.
