SJVIA keeps $10.6 million IBNR reserve; consultants outline county deficits and pharmacy drivers
February 28, 2026 | Tulare County, California
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The San Joaquin Valley Insurance Authority board voted to maintain its incurred-but-not-reported (IBNR) claim reserve at $10,600,000 for at least six months while staff and consultants gather additional runout data and finalize year‑end reports.
Keenan consultant Borden Darm presented a preliminary FY 2026–27 budget that projects roughly $161 million in revenue and nearly the same amount in expenses, leaving a preliminary positive balance of about $1.3 million, based on assumed enrollment and trend rates. "We developed the preliminary budget for fiscal year 26–27," Darm said, noting the projection is based on current head counts, enrollment assumptions and trend factors and will be finalized in July when more plan experience is available.
Keenan’s plan experience presentation showed an overall 2025 accumulated deficit that fell to about $3.4 million after accounting for prescription drug rebates. "Tulare County experienced a deficit of $4,400,000," Eddie Barfield of Keenan told the board, and he outlined corrective actions Tulare County implemented for 2026 — including plan design changes and a higher emergency-room copay. Barfield also said SJVIA’s transition to the Carillon RX pharmacy benefit manager was projected to generate roughly $3,400,000 in savings, with Tulare County’s proportional share estimated at about $1,400,000.
County staff earlier reviewed cash-flow positions: Jose Lehi reported a weekly cash average of $41,749,174 for the period from Dec. 15, 2025, through Feb. 9, 2026, with a cash balance of $40,253,535 as of Feb. 9; after deducting IBNR, stabilization and settlement amounts the reported excess cash was $1,899,189.
On the IBNR item, Keenan described a technical model change that would have supported a reduction of IBNR to $8.5 million but recommended retaining the current $10.6 million level until the June 30 runout data are available. "The recommendation before you is that we stay at 10,600,000 at least for another six months," Borden Darm said. Supervisor Magsig moved to adopt that recommendation; Supervisor Bridal seconded. The motion carried by voice vote; one abstention was recorded and Supervisor Mendez was absent.
Board members pressed consultants for more county‑level detail on trend assumptions and on the drivers of prescription rebates. Kenan Pharmacy Services noted that specialty drugs — including GLP‑1 class agents such as Wegovy and Ozempic — have been a major cost and rebate driver and said it would provide additional breakdowns in future reports.
Next steps: staff and Keenan will review claims runout through May and return to the board with updated IBNR analysis and the finalized budget at the July meeting. The board’s next listed meeting is May 1 in Fresno.
Keenan consultant Borden Darm presented a preliminary FY 2026–27 budget that projects roughly $161 million in revenue and nearly the same amount in expenses, leaving a preliminary positive balance of about $1.3 million, based on assumed enrollment and trend rates. "We developed the preliminary budget for fiscal year 26–27," Darm said, noting the projection is based on current head counts, enrollment assumptions and trend factors and will be finalized in July when more plan experience is available.
Keenan’s plan experience presentation showed an overall 2025 accumulated deficit that fell to about $3.4 million after accounting for prescription drug rebates. "Tulare County experienced a deficit of $4,400,000," Eddie Barfield of Keenan told the board, and he outlined corrective actions Tulare County implemented for 2026 — including plan design changes and a higher emergency-room copay. Barfield also said SJVIA’s transition to the Carillon RX pharmacy benefit manager was projected to generate roughly $3,400,000 in savings, with Tulare County’s proportional share estimated at about $1,400,000.
County staff earlier reviewed cash-flow positions: Jose Lehi reported a weekly cash average of $41,749,174 for the period from Dec. 15, 2025, through Feb. 9, 2026, with a cash balance of $40,253,535 as of Feb. 9; after deducting IBNR, stabilization and settlement amounts the reported excess cash was $1,899,189.
On the IBNR item, Keenan described a technical model change that would have supported a reduction of IBNR to $8.5 million but recommended retaining the current $10.6 million level until the June 30 runout data are available. "The recommendation before you is that we stay at 10,600,000 at least for another six months," Borden Darm said. Supervisor Magsig moved to adopt that recommendation; Supervisor Bridal seconded. The motion carried by voice vote; one abstention was recorded and Supervisor Mendez was absent.
Board members pressed consultants for more county‑level detail on trend assumptions and on the drivers of prescription rebates. Kenan Pharmacy Services noted that specialty drugs — including GLP‑1 class agents such as Wegovy and Ozempic — have been a major cost and rebate driver and said it would provide additional breakdowns in future reports.
Next steps: staff and Keenan will review claims runout through May and return to the board with updated IBNR analysis and the finalized budget at the July meeting. The board’s next listed meeting is May 1 in Fresno.
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