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Los Lunas staff recommend switching employee health plan to Presbyterian to curb premium growth
Summary
Benefits staff presented RFP results showing Presbyterian offered a level-funded plan with no first-year premium increase, $100,000 implementation credits, gym membership coverage, COBRA admin savings, and a mechanism that could limit second-year increases based on medical loss ratio.
At the April budget workshop, benefits staff recommended the Village move from Blue Cross Blue Shield to a Presbyterian level-funded plan after evaluating RFP responses from three carriers.
Marcos Castillo, presenting the employee insurance tab with benefits consultant Fred Carbajal, described Presbyterian’s offer: "Presbyterian is offering a $0.00 increase to our current premium and offering us a $100,000 in implementation credits." Staff told the council that Presbyterian would allow continued access to services within the Lovelace Health System at higher out-of-network cost (a proposed deductible increase from $500 to $750 for out-of-network care) and would cap second‑year rate increases based on the Village's medical loss ratio.
Staff also reported the Village’s current medical loss ratio is 86% because of a small number of large claims late in the fiscal year. Other operational savings cited included absorbing COBRA administration fees (about $0.74 per employee per month) and full coverage for many local gym memberships. Councilors asked whether BCBS could change its offer and were told the carrier’s proposal appeared firm; councilors indicated support for switching pending the usual procurement and contract steps.
