[{"_1":2,"_111":-5,"_112":-5},"loaderData",{"_3":4,"_26":27},"root",{"_5":6,"_17":10,"_18":19,"_20":21,"_22":10,"_23":-5,"_24":-5,"_25":10},"user",{"_7":8,"_9":10,"_11":10,"_12":-5,"_13":-5,"_14":15,"_16":-5},"roles",[],"isAuthenticated",false,"isPremium","planName","subscriptionStatus","featureFlags",{},"insightsBudget","isDevelopmentHost","userPreferences",{},"recaptchaSiteKey","6LcvOJcUAAAAAHsB-gPGfGktcRlKpH7OTIU_dMTD","isImpersonating","impersonation","affiliateStatus","isFreedomPortal","routes/v2/article/layout",{"_28":29,"_30":31},"notFound",true,"relatedArticles",[32,75,87,99],{"_33":34,"_35":36,"_37":38,"_39":40,"_41":42,"_43":44,"_45":46,"_47":48,"_49":50,"_51":52,"_53":54,"_55":56,"_57":58,"_59":60,"_61":62,"_63":64,"_65":66,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},"mediaId",6088497,"mediaKeyId","2880248-c2a1a4fc2a102388dff5811cf742916d","parentId",2880248,"title","Rockingham County weighs 9% health-plan cost rise as stop‑loss premiums surge; stop‑loss options remain under review","audioSeconds",5217,"startMs",5226000,"endMs",9000,"viewUrl","/Search/View?dp=1&key=2880248-c2a1a4fc2a102388dff5811cf742916d&start=5226&end=9","thumbnailUrl","https://assets.pipeline.soar.com/2880248-c2a1a4fc2a102388dff5811cf742916d/thumbnail_5226000.jpg","articleUrl","/articles/6088497/Rockingham-County/New-Hampshire/Rockingham-County-weighs-9-health-plan-cost-rise-as-stoploss-premiums-surge-stoploss-options-remain-under-review","mediaUrl","https://secure.pipeline.soar.com/6088497-2e5f198dbf0145dcc43ad5c2e989645c/orig.mp4?Expires=1771085425&Signature=SV6oybb9pnm8ZYjlXnAgqlx53CBDqsa98p1aSvyvZdC~ZGeCO8gRcXZcT~wrjxwGQMMkmrrPcHol0aIk6nc-owg9x1jL51jkMY0caMgJsORu5xZ2rzW6jYeQPwUNESeqQnDuqnPMg9jjKleBzb6HAiLqwDnlZ5qsxIwbFKDdOWMxDYtWPwFCS6vRX8aX6aC1toP5IOKS9UUApUWWQztNMjy45k47N7qArc5If~klzTILeo0SxuZV1db6vXVqBpG76VAWuh0wWjBN2bGHxiuk811Qz3rG4if8osAfHcz2JZ~KHwOBcyNH68dSf7dOfMqUOu~6tOQ771i7WcVVM5fWgw__&Key-Pair-Id=KUT5TJCACFTXG","author","Rockingham County NH","date","2025-04-05T04:23:26.823Z","article","Rockingham County commissioners heard a detailed benefits briefing April 3 from Gallagher consultants and county staff showing a projected all‑in increase of about 9% for the county’s self‑funded medical plan for the 2025–26 plan year.

The briefing, led by Gallagher and county finance staff, said most of the upward pressure comes from higher stop‑loss (catastrophic‑claim) pricing and recent high‑dollar claims. Gallagher reported a proposed stop‑loss renewal that would raise specific stop‑loss costs by about 45%, which the consultant said equates to roughly $384,000 in additional premium; an alternative that increases the specific deductible to $200,000 would trim that jump to roughly 25%, according to the presentation. Gallagher also identified two current claimants they flagged as likely to exceed the county’s specific stop‑loss threshold and said the carrier underwriting option that assigns “lasers” to those claimants would add an estimated $410,000 of potential direct liability if those individuals exhaust their laser amounts.

Why it matters: health‑plan costs are paid from a dedicated internal service fund and from departmental contributions; large swings in stop‑loss pricing or catastrophic reimbursements affect the county’s reserves and the budget the commissioners approve. Finance staff told the board there remains multiple millions of dollars in the county’s health fund but that increases of the size shown would use more reserves or require higher employer and/or employee contributions.

Gallagher summarized options the county can take before finalizing the renewal: (a) accept the carriers’ straight renewal (the highest immediate premium increase), (b) take a higher deductible (for example $200,000) to lower stop‑loss premium, or (c) accept a renewal with claimant‑specific lasers (lower premium now but explicit potential liabilities). Gallagher said carriers other than the incumbent were either non‑competitive or declined to quote at current experience levels, so switching carriers does not guarantee lower costs this year.

Commission discussion and next steps: Commissioners and staff focused questions on the tradeoffs between a higher stop‑loss deductible and the laser option. Several commissioners said they preferred not to accept lasers unless the premium savings clearly exceeded the county’s potential exposure. County finance staff and Gallagher agreed to run final price comparisons and draft a motion for the board to act on at a near‑term meeting; Gallagher expects final stop‑loss quotations to be available in mid‑April and recommended waiting for those to avoid locking into a worst‑case renewal.

Context and supporting details: Gallagher reported that the plan’s recent year‑to‑date loss ratio is elevated (above 100% in the most recent reporting period), driven by a small number of very large medical claims; five members account for a disproportionate share of recent medical spend, and one large case is expected to fall off COBRA at year end. Gallagher also reviewed pharmacy and dental renewals: the dental contract was under a two‑year rate guarantee with no admin increase for 2025, while the pharmacy contract is part of the incumbent medical administration arrangement where prescription rebates are shared with the county (75% returned to the county under current contract language).

What the board directed: Commissioners asked staff to return with specific motion language and side‑by‑side cost scenarios (status‑quo renewal, higher deductible, renewal with lasers and expected county cash‑flow impacts) and to provide quarterly stop‑loss receivable projections for internal‑service fund accounting so that year‑end financial statements reflect expected reimbursements. No formal vote on the medical renewal was taken April 3.

Ending: Staff said they would provide final stop‑loss quotes and modeled budget impacts to the commissioners for a decision at the next available meeting, and that quarterly reporting will include incurred‑but‑not‑reported estimates for stop‑loss reimbursements to aid fiscal planning.","mediaType","Video","parentTitle","Board of Commissioners Meeting 04/03/2025","oneSentenceSummary","Rockingham County commissioners heard a detailed benefits briefing April 3 from Gallagher consultants and county staff showing a projected all‑in increase of about 9% for the county’s self‑funded medical plan for the 2025–26 plan year.","taxTitle","Rockingham County, New Hampshire","taxId",54226,"location","headline","","shortSummary",{"_33":76,"_35":36,"_37":38,"_39":77,"_41":78,"_43":79,"_45":80,"_47":81,"_49":82,"_51":83,"_53":84,"_55":56,"_57":58,"_59":85,"_61":62,"_63":64,"_65":86,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6088482,"Commissioners approve multiple bid waivers, table a uniform contract and table a vehicle transfer amid procurement questions",3960,1440000,5400000,"/Search/View?dp=1&key=2880248-c2a1a4fc2a102388dff5811cf742916d&start=1440&end=5400","https://assets.pipeline.soar.com/2880248-c2a1a4fc2a102388dff5811cf742916d/thumbnail_1440000.jpg","/articles/6088482/Rockingham-County/New-Hampshire/Commissioners-approve-multiple-bid-waivers-table-a-uniform-contract-and-table-a-vehicle-transfer-amid-procurement-questions","https://secure.pipeline.soar.com/6088482-3de6592879d72aa55d2bb48fe1293ec8/orig.mp4?Expires=1771085425&Signature=eb0JGHIH6AwC3ajHFC~uTgu~IRpeZ2~nJhWGj7gGqFjCNJwEgCxQbhiA-~~vjLufdXCg9pNBvxCNX3hhh6MVB~wy~~mDnhg-V8gfFFTBeekXGhmhy3tD0b2ujC9K8P2ipTctIjhSkvdPNYVnyn91CUawb5omLzUS7~OolbntG07GGgr6AYur8Y88uSSWPkPL-uUvh3YYhAxsUYqbvNw9WWpFTISPTjTACTlG~FHpuoC-9zSaiTZQF7~j~CHFeuo1Y-3NQwbtWb2xifFNL~KN17-M4tzomrKDXqCriyahtKi8x4mXaXP5kUdURE-cjwHOJl7p4CYBffhU13t8BpmcmQ__&Key-Pair-Id=KUT5TJCACFTXG","The Rockingham County Board of Commissioners approved a set of procurement items April 3 and deferred others pending additional information.

Approved items: The board approved bid waivers and contract renewals for the county attorney’s office and other departments. Key approvals included:
- A one‑year renewal and license with Copel Solutions (CalCal database) for the county attorney’s office in the amount of $27,500, with the chair authorized to sign documents as recommended by the county attorney.
- A renewal with Westlaw (noted in the meeting as a renewal agreement) for legal research/services in the amount of $12,812.24.
- A bid waiver request and award to Honeywell International for security and camera installations at the corrections department, totaling $147,667.01; staff said the Honeywell equipment ties to existing Honeywell infrastructure and the vendor was recommended by the facilities/IT senior director.
- Assignment of an engagement letter from Markham/Blanton to CBIZ CPs PC for audit services (memorializing a corporate change), authorized as presented by the senior director of finance.

Tabled items: The board tabled at least two procurement items so staff could return with additional documentation or to follow the same waiver process used by the county attorney’s office:
- A proposed contract extension with the county’s uniform vendor (Neptune Uniforms) was tabled pending a formal bid‑waiver justification and additional documentation; commissioners asked staff to return with a waiver request or to go to bid.
- A requested line‑item transfer of approximately $168,000 from an inmate‑placement line to equipment (a vehicle) was also tabled so commissioners can review third‑quarter numbers and fund‑balance projections before committing funds.

Other consent votes and administrative actions: The board approved meeting minutes for March 6 and the public March 13 session with an amendment, and they approved sealing certain nonpublic minutes under RSA 91‑A language. The board also approved travel and training requests, an engagement assignment for auditors (Markham→CBIZ), and various consent motions recorded on the agenda.

Why it matters: The Honeywell waiver and the attorney‑office license renewals are operationally important (security and legal services). The tabled items show commissioners seeking a more consistent wafer/justification approach and greater budget clarity before committing to multi‑year extensions or line‑item transfers.

Ending: Staff will return with the Neptune uniform documentation and a revised line‑item transfer request after third‑quarter results for commissioners to review; approved vendors will proceed with contract execution.","On April 3 the Rockingham County Board approved several vendor waivers and agreements — including software and security system renewals — agreed to a commercial loan/engagement assignment and tabled a uniform provider extension and a $168,000 vehicle line‑item transfer for later review.",{"_33":88,"_35":36,"_37":38,"_39":89,"_41":90,"_43":91,"_45":92,"_47":93,"_49":94,"_51":95,"_53":96,"_55":56,"_57":58,"_59":97,"_61":62,"_63":64,"_65":98,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6088487,"Long‑term care reports: agency staffing declines, direct hires rise; equipment purchases and on‑site medical services approved",3368,352000,3720000,"/Search/View?dp=1&key=2880248-c2a1a4fc2a102388dff5811cf742916d&start=352&end=3720","https://assets.pipeline.soar.com/2880248-c2a1a4fc2a102388dff5811cf742916d/thumbnail_352000.jpg","/articles/6088487/Rockingham-County/New-Hampshire/Longterm-care-reports-agency-staffing-declines-direct-hires-rise-equipment-purchases-and-onsite-medical-services-approved","https://secure.pipeline.soar.com/6088487-068e1d20b3845a9147e500a21574d73e/orig.mp4?Expires=1771085425&Signature=W91rNK8rx6P-SSIxA~4WxzsdnAkdfS0smT8jcByo6XHKwn6C-4vTUAIz7jlXJJ1gclw26MfX70HLdjKVh3KNljOPZ8ad86umkOnObagbgyb5MEYWXdardt00XG5WabueTrwBMZyvZ7kTSyq0CQ6NF64dT~pwD5iPfjzD-NmdSrVZ-fQuepVTJDmV27huM3yEei-GmIQ6CZMb9KPF4wNSXHr~0UcER28X7RKPb0PrUMO75vEC-RjPSYy20T-g6HBPWznFXjfPnPgbY~6zmbhQbsjlMhY6~hwrExxj1tfF4WAfbIVVQxCRZ4nWpJXETTKlR~6Vd8z28bRubShmPVRA-Q__&Key-Pair-Id=KUT5TJCACFTXG","Rockingham County’s long‑term care leadership told commissioners April 3 that the county had significantly reduced reliance on agency nursing contracts over the past six months and replaced many temporary contracts with county hires, improving staffing stability and easing agency costs.

Staffing update: The long‑term care director said the county reduced about 20 agency contracts from a prior high in the 70s down to roughly the low 50s and had converted several per‑diem LPN/LNA positions to full‑time county employees, with more conversions planned. Staff credited an expedited recruitment workflow (\"ND Quick Apply\" referenced in the meeting) and weekly labor management meetings for faster onboarding and fewer overtime hours.

Purchases and contracts approved: Commissioners approved several procurement items for long‑term care departments during the consent and business agenda:
- A bid waiver and purchase with Yankee Equipment for a new commercial laundry washer (model and capacity noted by staff) in the amount of $22,869.02, recommended by the senior director of long‑term care services. Staff said an RFP produced no responses and the vendor is the only local source for the brand already in use.
- A contract for on‑site primary care services with Vantage Healthcare LLC for periodic on‑site provider visits (scheduled to begin 05/05/2025); staff said the company will bill residents’ insurance and there is no direct county cost for the service. Commissioners approved the engagement to improve access and reduce transports and hospitalizations.
- An adult medical day care request for a resident (dated 03/24/2025) for a two‑day‑per‑week placement billed at $80 per day was approved; staff said existing long‑term care budget lines can support the placement.

Other operational items: Staff reported ongoing work on med‑B audits and a recent mock survey, and that Sodexo (food service) had forwarded a contract for review. Nursing home census and infection surveillance were given: a nursing‑home census of 46 and an assisted‑living census with two staff COVID cases and one resident case at the time of the meeting; staff said infection control and surveys are active priorities.

Why it matters: The shift from agency to county staff reduces an expensive budget line item and strengthens workforce continuity for resident care. The Vantage Healthcare pilot aims to improve access to primary care for residents without adding county operating cost, according to staff.

Ending: Commissioners asked to be kept informed of the Vantage pilot’s results and of any further equipment needs; staff will return with any contract documents and budget adjustments as needed.","Long‑term care leaders reported a roughly 30% drop in agency‑contracted staffing as the county converted many roles to county employees; commissioners approved multiple long‑term care purchases including a new bridal washing machine and on‑site medical provider pilot that will bill insurance, at no direct county cost.",{"_33":100,"_35":36,"_37":38,"_39":101,"_41":102,"_43":103,"_45":104,"_47":105,"_49":106,"_51":107,"_53":108,"_55":56,"_57":58,"_59":109,"_61":62,"_63":64,"_65":110,"_67":68,"_69":70,"_71":68,"_72":73,"_74":73},6088492,"Rockingham County officials warn of deep fund‑balance use as budget season opens; delegation outreach planned",180,1207000,1387000,"/Search/View?dp=1&key=2880248-c2a1a4fc2a102388dff5811cf742916d&start=1207&end=1387","https://assets.pipeline.soar.com/2880248-c2a1a4fc2a102388dff5811cf742916d/thumbnail_1207000.jpg","/articles/6088492/Rockingham-County/New-Hampshire/Rockingham-County-officials-warn-of-deep-fundbalance-use-as-budget-season-opens-delegation-outreach-planned","https://secure.pipeline.soar.com/6088492-f91316ba43bd407dc6da6191deb1bc6a/orig.mp4?Expires=1771085425&Signature=fz0jPxxTJNPrbWrCWBgJUBIRQDPbM--E-vcFqqlEpHLOeoLfQfideYNDlY6Zy7E-IN4OK742dnvickz~IIHuGeyH9DUsMQgc0C0pA7hZ1MiYc72w8ph-8lGXZaqhWoXv258UJqLsHh8O1LeV3qYlAUeQUTzoSQ9Yl325riM997Z-V1RR1bW87mRD1D0I87mlzS6f5aJkAtRmbdmcyQiRlZgFkRXGehJITjRO60m~-aufDyUDFwIGIdVCBZ2HXSHHP4Ms5JRWjDt3UvGH0mp8-jUHIh22iBqSOHjFr0PE27Lr6pDMgGZSOiEntCzcsRL7EZ0lrYGZiZzFPhDviLu9Bw__&Key-Pair-Id=KUT5TJCACFTXG","Rockingham County finance and administration staff told the Board of Commissioners April 3 that the county’s draft budget faces sharp pressures and that the current proposal would require using nearly $18 million of fund balance to balance the spending plan.

Why it matters: Commissioners said that magnitude of fund‑balance use is “jarring” and would require difficult decisions in budget hearings; staff and commissioners described a compressed calendar and early outreach to the county delegation to seek support and to explain impacts of state‑level proposals that could affect county revenues and costs.

Details from the meeting: County officials said several state‑level developments could affect county finances, including a proposed amendment to House Bill 2 that would create a new “Group 3” retirement contribution for certain employees and would require counties to pay roughly 10–11% (the consultant’s phrase) on those employees’ compensation for an unfunded liability — a change staff said could materially raise county retirement costs starting in 2026. The county’s register of deeds and finance staff reported strong transfer‑tax receipts year to date that have helped revenue collections but warned that real‑estate market volatility makes next‑year forecasting uncertain.

Commission activity: Commissioners confirmed the subcommittee schedule for late April through mid‑May, with delegation and subcommittee hearings expected to run roughly April 28 to May 13 to line up with the state representative/delegation calendar. Commissioners asked staff to prepare printed and electronic budget packets and to support delegation questions with written narratives where needed; staff said they will provide supplemental narratives for line‑item transfer requests the commissioners plan to present to the delegation.

Nonprofit funding: As part of the budget roll‑up staff reported that several long‑time non‑county nonprofit recipients failed to submit required applications and staff inserted $1 placeholder allocations for four organizations. Commissioners discussed whether to leave the placeholders or remove them and asked for further review before the delegation hearings.

Ending: Commissioners set an aggressive timeline of subcommittee meetings and requested additional context for departmental requests before the delegation meets. No binding budget decisions were made April 3; work sessions will continue.","County leaders told commissioners April 3 that to meet next year’s budget as proposed the county would need to draw nearly $18 million from fund balance, prompting early outreach to the county delegation and scheduling of subcommittee and delegation budget meetings.","actionData","errors"]

Article not found

Rockingham County weighs 9% health-plan cost rise as stop‑loss premiums surge; stop‑loss options remain under review

Commissioners approve multiple bid waivers, table a uniform contract and table a vehicle transfer amid procurement questions

Long‑term care reports: agency staffing declines, direct hires rise; equipment purchases and on‑site medical services approved

Rockingham County officials warn of deep fund‑balance use as budget season opens; delegation outreach planned