Seminole County approves 2027 benefits changes, directs staff to investigate 2028 RFP

The Seminole County Board of County Commissioners on July 1 approved staff recommendations to revise employee health plan design and employee contributions for plan year 2027 and to move pharmacy contracting toward Cigna's acquisition‑cost‑plus model, while directing staff to investigate a formal request for proposals (RFP) for plan year 2028.

Human Resources Director Christina Brandolini introduced the update and turned the presentation over to Tim Jeks of the Office of Management and Budget, who presented the county’s forecast for the self‑funded health plan. "The FY '27 budget is based on an average increase of 12% for all premium lines," Jeks said, and staff projected plan reserves of about $11 million under the proposed assumptions.

Consultants from Alliant and county staff reviewed proposed plan design changes intended to align deductibles and out‑of‑pocket maximums with market norms and to modestly increase employee contributions on higher‑cost tiers. The consultants also described pharmacy‑benefit options and estimated potential pharmacy savings: a revised acquisition‑cost‑plus arrangement with Cigna could reduce the county’s drug spend by roughly $852,000 in 2027 under their model, while other PBM scenarios produced similar ranges depending on assumptions about international sourcing and patient assistance programs.

"We are recommending that the board approve the plan design changes for plan year 2027, approve the proposed monthly employee contributions for 2027, approving moving the pharmacy to the Cigna acquisition cost plus as the pharmacy benefit manager for plan year 2027, and approve staff and Alliant to initiate an RFP for plan year 2028," Brandolini said.

Commissioners questioned whether a full RFP was necessary and discussed alternatives, including market evaluations and targeted negotiations that might limit disruption to employees. Commissioner Lockhart (district commissioner) urged staff to seek information from other carriers before committing to an RFP. Several commissioners said their preference was to avoid unnecessary disruption to employees but to keep options open if the market warranted a change.

After discussion, a motion passed unanimously to approve the staff recommendations with an amendment: staff was authorized to "investigate initiating an RFP plan for 2028" and return with analysis and a recommendation. The board asked staff to provide that analysis by November so any procurement decisions could be ready for implementation in January if needed.

Staff also committed to improved employee communications, including Medicare education and an upcoming financial expo that will host speakers on Medicare and Social Security.

The action is administrative and does not change coverage effective dates beyond plan year 2027; staff will return with detailed numbers and an implementation timeline if they recommend pursuing an RFP.