Gallagher representatives Matthew Pukel and Brian Carlson gave a detailed presentation to the Rockingham County Board of Commissioners on Dec. 4, 2025, warning that recent high-cost claims have pushed the county's self-funded health plan into a volatile stop-loss market and outlining steps to reduce future exposure.

Why it matters: County staff expect the employee benefits renewal in July will reflect significant stop-loss market movement unless the county adopts several cost-control measures. Gallagher said a small number of high-cost claimants accounted for nearly half of recent costs and that stop-loss carriers typically use nine months of experience to set firm renewal pricing.

Pukel summarized recommended actions: go out to market for stop-loss coverage, assess pharmacy arrangements (including a carve-out analysis where feasible), and pursue point solutions for the highest-cost conditions. He described tactics such as home-infusion alternatives (a vendor Gallagher calls QuantiPha), musculoskeletal (MSK) care-path programs, and consumer navigation tools to steer employees to higher-value providers.

Allison Kielakoski (HR) and commissioners pressed Gallagher for specifics. Kielakoski noted some large claims may fall off the county's experience in coming months; Gallagher responded that market pricing depends on the trailing experience and that the firm would produce projections once it had more recent claims data. Gallagher gave a working estimate of stop-loss trend guidance and emphasized that stop-loss pricing can materially affect the county's budget.

Direct quote: "Stop loss trend is 20%" was stated by a Gallagher representative during the presentation as context for planning and market outreach (presentation remarks).

Next steps: Gallagher asked county staff to provide claims and utilization data so it can run scenarios and return with concrete options and projected savings. Commissioners directed staff to share the requested data and to schedule Gallagher follow-up discussions in the months ahead.