County health plan projects surplus through 2027 but faces stop-loss 'laser' risk

Jeff Mudrack, a presenter on the county's health plan, told the fiscal court the plan closed 2025 with funding of $4,000,008.87 and total expenses that left the plan in the black.

"Total plan funding was $4,000,008.87," Mudrack said, presenting the 2025 reconciliation and noting a near-term reserve. He reviewed 2026 estimates that project roughly $5.2 million in funding and about $4.37 million in expenses, which would leave an expected year-end cushion of about $826,000.

Mudrack then turned to 2027 projections and the county's stop-loss arrangements. He explained the county self-insures claims up to $125,000 and buys reinsurance above that threshold. "The only real insurance we have is on anybody who has a claim in excess of a 125,000," he said, and he warned of named "lasers" in Anthem's quote that would single out specific high-cost members for additional exposure.

DJ Story, who led stop-loss marketing, said his team solicited quotes from 14 markets; most declined because of claims activity. He noted the incumbent stop-loss carrier, ISU Companion, has offered renewal terms with a no-new-laser provision and a 50% rate cap for the current renewal but has not yet confirmed whether those protections will persist into subsequent renewals.

Both presenters recommended delaying a final procurement decision until ISU provides confirmed September claims data and firm renewal language. The judge and members asked about building a formal reserve; Mudrack said the county's current budgeted contribution is $5.1 million and that, on conservative assumptions, the plan would still end 2027 with a positive balance even if one identified laser required budgeting.

Next steps: staff will obtain ISU's confirmed renewal terms after September claims are processed and aim to bring a decision to the court by Oct. 22.