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County staff warn of 173% medical loss ratio; plan to market health coverage
Summary
Benefits staff told the committee the group’s June medical loss ratio is 173% with several large claimants; they plan to market the group to other carriers and request rate relief from Blue Cross Blue Shield.
A staff member reported to the committee that the county’s group health plan showed a June medical loss ratio of 173%, driven by four high-claim cases with individual claim amounts ranging from about $108,000 to $333,000.
"Medical loss ratio for June is at 173 percent, which is quite high," the staff member said, and added that additional details have been requested from the carrier representative. The employee-benefits team said they will put the group out to bid to other carriers and use that competitive data to press Blue Cross Blue Shield for better rates and to request rate relief.
Committee members asked clarifying questions about timing and renewal mechanics. Staff said the renewal process typically begins about 75 days before renewal and they will forward any carrier detail to the committee when available.
