County leaders discuss switching county clinic provider and shifting employee premium contributions to rein in health costs
Summary
Commissioners and staff reviewed expected 2025 health costs, a proposed move from the county's current clinic arrangement toward an independent clinic (Marathon) or brokered solution (McGriff), and debated raising employee premium shares to reduce county spending; officials estimated potential savings if utilization targets are met.
County officials spent substantial time reviewing the county's health-insurance costs, clinic utilization and possible contract changes to reduce premium growth. County staff reported 411 employees were enrolled in the county plan (214 single; 44 employee+spouse; 95 employee+children; 58 family) and that total 2025 health-related costs (medical, prescription, admin, stop-loss, dental, vision and basic disability/life) were projected around $7.17 million, or roughly $17,447 per enrolled employee based on current enrollment.
Commissioners discussed moving the county clinic contract away from the current arrangement (described in conversation as 'IU clinic' and Apex administration) to a different vendor or clinic model (Marathon and McGriff were discussed). One commissioner said moving prescriptions and utilitization to a new clinic could reduce county costs by approximately $360,000 annually, assuming utilization remains stable. Staff proposed a two-tier per-member-per-month pricing model to encourage on-site clinic use (lower rates for employees who use the clinic and higher rates for dependents), and said negotiated administrative and reinsurance terms remain under discussion.
Employee premium-share scenarios: commissioners weighed increasing employee contributions to recapture premium costs. Staff presented illustrative splits (county/employee) and their budget effects: moving to an 80/20 split (employee pays 20%) would reduce county costs materially but would raise employee annual costs by roughly $3,500 for a family plan in the speakers' rough illustration; an 85/15 split would raise employee costs by roughly $1,400 annually; a 90/10 split by about $680 annually. Officials noted the county currently operates near a 92/8 position and that employee premiums have been largely unchanged for many years.
Contract and procurement matters: staff said they are negotiating rate caps and reinsurance arrangements with broker McGriff and specialty carriers to cap stop-loss exposure and reduce fee structures tied to billed charges. Commissioners instructed staff to assume a conservative recurring savings of $500,000 for budgeting purposes if negotiations succeed and to plan how any realized savings would be allocated between lowering county premium costs and employee contributions.
Why it matters: health-care premiums and the clinic contract are the largest line items in the county benefit fund, and officials said aligning clinic utilization and premium design could yield multi-hundred-thousand-dollar savings over time. Commissioners emphasized a multi-year approach: achieving 50% clinic utilization would likely take time and the savings would accrue gradually. No contract change was finalized at the meeting; staff will continue negotiations and return with concrete proposals and rate grids.
