Lorain County adopts new health plans and a spousal surcharge; actuary warns reserves shrinking

The Board accepted an actuarial report from Chelko Consulting and approved changes to the county employee health plan effective Jan. 1, 2027, including three medical plan options, a four‑tier premium structure (single, single+spouse, single+child(ren), family) and a $200/month working‑spouse surcharge.

Actuary Steve Parsons said plan reserves have declined from about $20.9 million at the end of 2023 to a projected $9.17 million at the end of 2026. Parsons explained the recommendation: "Our recommendation for 1/1/27 and to break even is 10.7% increase" and said a 14% increase would be consistent with the county's reserve policy to restore target levels. Parsons attributed the deterioration mainly to growth in high‑cost claimants (53 claimants costing about $13.7 million in the most recent 12‑month window).

Kelsey Fenukin of the Oswald Company presented proposed plan designs intended to offer choice while limiting premium growth. Fenukin summarized the package: two PPOs and one HSA‑eligible high‑deductible plan, changes to pharmacy copays and a brand‑assistance program (TrueScripts). She also proposed moving to a four‑tier premium structure and implementing a $200/month working‑spouse surcharge for spouses who have access to employer coverage but remain on the county plan.

Commissioners adopted Res. No. 26‑424 to accept the actuary report and to establish the premiums and plan structure. Moore, Gallagher and Riddell voted in favor. The board instructed staff to coordinate implementation details with payroll and union representatives and to continue dialogue with labor representatives about plan selection and employee contributions.

Employees and labor representatives will see options and enrollment materials before the Jan. 1, 2027 effective date; the board noted that some plan choices could shift members between plan types and said they expect modest migration to the new HDHP.