Grand Forks County commissioners spent an extended portion of a budget work session discussing a projected rise in employee health-insurance premiums and possible changes to plan design and retirement pickups.

County staff said preliminary estimates show the county’s current health plan could cost roughly $4.2 million at present enrollment and rise to about $4.7 million with a 12% increase, about $4.8 million with 14% and roughly $5.0 million with a 19% increase. Staff described several mitigation options, including offering an alternative Dakota Blue Ultra plan tied to an HSA, adjusting employer contribution rules, or redesigning HRA funding levels.

Why it matters: higher insurance costs would increase the county’s payroll-related expenditures and could force tradeoffs in department budgets or reserves if commissioners do not identify offsetting revenues.

County staff explained plan mechanics and examples: the county currently funds three plan levels at differing employer rates (staff described the county paying about 90% of single premiums and about 82% for employee-plus-children or family coverage). The broker’s illustrative scenarios — labeled “illustrative only” and based on 2025 enrollment counts — showed total premium costs near $4.2 million under current rates, rising toward $5.0 million under a 19% increase.

Staff also reviewed design options. One option is Dakota Blue Ultra, a narrower-network plan that could reduce premiums by roughly 15% but would limit “in-network” providers to the Ultra network; out-of-network care would carry higher member cost-sharing. Example plan designs discussed included a $3,300 deductible 80/20 plan and a $5,000 deductible plan that pays 100% after the deductible. Another option was to pair lower-premium plan designs with a health savings account (HSA) funded by the county; staff cited a recommendation of $600 per year funded at $50 per pay period as one illustrative approach. By contrast, the county’s current health reimbursement arrangement (HRA) was described as front‑loaded at plan-year start (examples: $2,100 single, $3,150 single+dependent, $4,200 family).

On retirement costs, staff reviewed the state retirement plan rules being phased in for new employees (referred to in the presentation as DC 25) and existing plans. Commissioners were told the employer share for public-safety retirement will increase by 1.23 percentage points in 2026 (from 11.4% to 12.63% as presented), which will raise county pension costs regardless of local choices on wages or benefits.

Commissioners’ direction and next steps: the board asked staff to produce comparison documents showing (a) the county’s current plan versus the Dakota Blue Ultra options, (b) the effect on out-of-network reimbursements, (c) HRA versus HSA funding methods and frequencies, and (d) a single uniform HRA/HSA funding alternative rather than different amounts by plan tier. Chair Schneider asked staff to present alternate employer-contribution levels and to bring clear dollar impacts for the next meeting. No formal policy change or vote occurred at this session.

Quotations in context: Michelle, a county staff member who presented the benefit scenarios, summarized the enrollment breakout and the broker’s illustrations: “We fund the 3 plans that we currently have at different rates. If you are on a single plan, the county pays 90% of the premium. If you are on employee plus children or you are on a family plan, the county pays 82% of your premium.” Chair Schneider said the board should “debate between HSA versus HRA” and asked staff to return with one consistent funding amount to consider.