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Plan running just under budget with $3.6M surplus; four claimants exceeded $750K
Summary
Lockton reported the State of Maine plan is running at 97.9% of budget year‑to‑date with an approximate $3.6M surplus; four individuals exceeded the $750,000 stop‑loss threshold with $2.2M reimbursed to date.
Lockton presented the quarterly plan experience summary showing that, through January 2026, total claims and expenses were 97.9% of the budget (a 0.3% increase from the prior month), producing an approximate year‑to‑date plan surplus of $3.6 million. Administrative payments by the State for vendor and claims administration totaled $9,311,174 for July 2025 through June 2026.
The report noted four individual claimants exceeded the $750,000 individual stop‑loss limit; the plan has received $2.2 million in reimbursements for those cases. In addition, thirty claimants exceeded $275,000 with combined claims of $16.3 million. Lockton and staff indicated these high‑cost cases and pharmacy trends were factors in recommending plan design and programmatic responses.
Data reported by status showed 93,760 active employees with claims (total plan cost $151,012,148) and 10,072 retirees with claims (total plan cost $19,226,132) through December 2025.
