Upson County keeps current cost split, approves Blue Cross Blue Shield renewal with $30,000 credit

Upson County commissioners voted June 4 to accept a Blue Cross Blue Shield renewal for the county's employee major medical plan and to keep the county-employee cost split at roughly 84% to 16%, after hearing that Cigna had proposed a 24% renewal increase and that Blue Cross offered a 14% rate increase plus a $30,000 administrative credit.

The vote came during a special-called meeting called to address the county's health insurance renewal and was prompted by higher-than-normal claims and several multi-hundred-thousand-dollar individual claims in the current plan. Alan, a benefits broker who presented renewal options, told the board, "we did receive a 24% increase from Cigna," and said Blue Cross's offer was a 14% increase with a $30,000 administrative credit to the county.

Why it matters: The decision affects county payroll deductions, the county budget for the remainder of this fiscal year and next year's budget discussions, and employees preparing for open enrollment, which staff said is scheduled to start June 7. Commissioners emphasized both the county's responsibility to employees and sensitivity to taxpayers as they considered several cost-sharing scenarios.

What the board heard and considered
- Claims and drivers: The broker reported multiple high-cost claimants, including at least five claims over $100,000 and a single high claim of about $325,000. Claims of $25,000 and above accounted for just under $2 million in plan spend, and the presenter described a loss ratio of roughly 1.23 ("they pay out 23% more in claims than they received in premium").

- Market options: Presenters said they solicited bids from the usual carriers and newer entrants; one newer option described as a boutique program would require members to complete a health assessment to reduce member cost sharing, but the brokers said they were not comfortable recommending that vendor without more references.

- Cost scenarios: The broker described three modeled approaches: 1) the county absorbs the increase (estimated impact about $403,000), 2) shift more of the increase to employees (the presenter described an adjusted split that would leave the county paying approximately $350,000), and 3) keep the existing percentage split (county ~84%, employees ~16%), which the presenter estimated would increase county spending by about $340,000 year over year. The broker also noted any employee-share changes must comply with the Affordable Care Act's limits on employee premium contributions.

Board action and follow-up direction
Commissioner Ellington made the motion to accept the Blue Cross Blue Shield renewal and keep the cost-sharing percentages the same as the prior year (the staff-presented baseline of roughly 84% employer / 16% employee), and Commissioner Watson seconded. The board voted unanimously in favor (Commissioners Jones, Bates, Watson, Ellington and Chairman Rue recorded "yes"). The motion carried.

The motion included direction that staff return with a formal policy recommendation by the September meeting to present options for setting a defined employer share for employees and a separate share for spouses/dependents (commissioners discussed potential future targets such as 85% employer for employee-only coverage and 65% for spouse/dependents as examples to be modeled).

Additional details and context
- Open enrollment and timing: Presenters stressed operational timing: carriers typically provide a formal renewal about 60 days before an effective date (July 1), and if the county changes carriers, the new carrier needs at least two weeks to onboard so employees have access on the effective date. The board discussed the tight calendar and the desire for staff to provide ongoing updates rather than last-minute material.

- Budget impact: Staff and commissioners discussed the immediate budget impact for the second half of the current fiscal year and the need to account for the increased premium cost during upcoming budget deliberations.

- Alternatives and longer-term goals: Presenters said the county's long-term aim is to build more control into benefits (for example, partial self-insurance and local partnerships) to reduce year-to-year market volatility, but they said current high claims make moving to partial self-insurance premature.

What's next: Staff will implement the renewal with Blue Cross Blue Shield for the county's major medical plan, proceed with open enrollment mechanics, and return with a staff recommendation and policy options by the September meeting that will model employer/employee shares and potential spousal/dependent surcharges or surrogates.

Ending: The board's vote resolves the immediate renewal under the timeline presented by brokers and gives staff direction to bring back policy alternatives this fall for a possible multi-year approach to benefits and cost control.