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County health plan shows high loss ratio; PBM review continues
Summary
Houchens Insurance presented Nov. 2025–June 2026 plan results: total paid claims about $2.89 million, maximum claims $3.21 million and a loss ratio of 90% (target 80%); three PBM vendors remain under consideration and no HSA design change was adopted for 2027.
Max Bawel of Houchens Insurance Group presented the county’s employee health plan financials for November 2025 through June 2026 and highlighted that the plan’s loss ratio was 90% against an 80% target. He reported total fixed costs of $672,151 and net total paid claims of $2,892,306, with maximum claims capacity of $3,210,048. The Dubois County clinic’s six‑month spend was $54,321.90, averaging $42.11 per employee per month, and the consultant reported clinic savings of $113,428.39.
Bawel said proposals from three Pharmacy Benefit Managers remain under review (TrueScripts, Med One and Smith Rx) and that staff will present findings at a future meeting. He and staff discussed possibly offering a Health Savings Account option, but the consensus at this meeting was to retain the current plan design for 2027.
