Mobile County weighs exit from LGHIP to pursue county self‑insured health plan, officials cite employee benefits

Mr. Carr, a county commissioner, told colleagues the proposal to leave the Local Government Health Insurance Program (LGHIP) is driven by concerns about employee coverage rather than immediate cost savings and asked commissioners to consider the resolution to withdraw participation effective Jan. 1, 2027.

Tim Smith, county staff overseeing the review, told the commission the county has been exploring alternatives with consultant Combs Allen and other advisers and that the recommended option is a self‑insured plan with stop‑loss (reinsurance) protections. "This is strictly about making sure our employees are well taken care of," Smith said, adding that the change could cost more or less than current premiums but that reinsurance limits the county's exposure.

Smith and other staff described several concrete benefits under the proposed plan: tighter control over covered services and deductibles, point‑of‑sale prescription handling to avoid later reimbursement delays, and the ability to negotiate on prescription pricing. Smith said one of the largest employee complaints has been prescription drug cost and reimbursement lag; moving to a point‑of‑sale model would eliminate the need for employees to submit reimbursement forms and would provide immediate coverage at the register.

Commission staff also described an intended partnership with the University of South Alabama to provide an on‑site or near‑site clinic for county employees. Staff said the initial arrangement would likely start with roughly 20 hours per week of nurse coverage, with the possibility of expanding to a full‑time on‑site nurse, and telehealth options would be available. "If you choose to use that clinic you pay nothing," Smith said, noting the university would bill the county for services and may offer discounts under negotiated arrangements.

Staff emphasized an urgent procedural deadline: the county must notify LGHIP by the end of the month to withdraw this year; otherwise the commission would generally have to wait a full year to make the change. Commissioners repeatedly framed the move as an employee‑focused decision, with Mr. Carr saying, "This is strictly for the employees. It is not necessarily a cost‑saving effort on the commission." Staff indicated an employee education campaign would follow final plan design and legal review.

Next steps: officials said legal review and final plan design are ongoing; commissioners were asked to consider the resolution at the next regular meeting to meet the notification deadline.

Ending: The commission heard staff detail implementation options and deadlines; no formal vote on the withdrawal was recorded during the June 18 conference session.