Blue Cross projects double‑digit renewal driven by concentrated high‑cost claims

Patrick Brown, group sales consultant for Blue Cross of Kansas, reviewed the county's renewal and the actuarial drivers behind the proposed increase. He said the carrier's experience period produced approximately $2.3 million in premium and about $1.8 million in claims paid to date.

"When those claims are fully accounted for, we will have paid out more $1.78 for in claims for every dollar they came in in premium," Brown said, noting the projected loss ratio was north of 100 percent during the experience window. He explained that incurred‑but‑not‑reported (IBNR) claims, trend, and utilization combine to produce a projected 14.1% increase if the county keeps the same plan design.

Brown emphasized concentration of large claims as the primary factor: 16 people in the county group had claims over $25,000 and together accounted for about $1.2 million of the $1.8 million in paid claims. The carrier said that level of concentration is high for a group of roughly 100 covered lives and that stop‑loss or plan design changes are typical responses.

Blue Cross and county staff discussed alternative plan designs — including moving to a higher deductible ($6,000 or $6,350 in examples) — or adopting supplemental approaches such as a MERP or reinsurance to manage volatility. Brown said a $6,000 deductible option showed a lower headline increase in the carrier's illustrations but that any change requires careful balancing of member exposure and county budget impact.

Commissioners expressed concern about timing: renewal is set for June 1 and a pending state revenue cap (House Bill 2745) could constrain the county's ability to raise revenue to meet higher health‑care costs. No final purchasing decision was made; staff and vendors agreed to follow up with more detailed proposals ahead of renewal.