Rocky Mount city officials heard a presentation on December council that a competitive bid could shield the city from a high‑cost individual claim exposed by Aetna's renewal proposal.

Mark, a Mark 3 representative, told the council Aetna's original renewal included about a $1,300,000 "laser" — "what a laser is, it's a pooling level for an individual," he said — but subsequent bids from Cigna, UHC and Blue Cross removed that laser and produced a comparable premium. He said Blue Cross's stop‑loss arrangement would place the city in a roughly $35–40 million block of business with built‑in protections, including a no‑new‑laser provision, a stop‑loss rate cap and a custom experience refund that returns money to high‑performing groups.

The consultant said the larger pool has produced refunds to members in recent years: about $2.7 million for 2022–23, $4.3 million for 2023–24 and an expected $6.8 million for 2024–25, and argued participation could add stability while offering the potential for distributions if the block performs well. "The bid process, though, did give us an opportunity to improve the risk profile for the city," he said.

Council members pressed staff on timing and administration. One councilmember asked why renewal materials arrived to council late; staff replied the original renewal was delivered to staff in September and the city directed a rebid to pursue savings. Council members also asked whether carving stop‑loss billing out of Aetna would create administrative burden. Lisa, who will audit invoices, said staff already reviews monthly Aetna statements line by line and can handle separate invoicing from Blue Cross.

On net cost, the presenter said the stop‑loss change coupled with other contract changes would be roughly budget neutral for 2026, with "the net effect was about a 2 percent decrease in total fixed cost." He cautioned the primary advantage of the Blue Cross option is risk mitigation: removal of recurring lasers, a rate cap on stop‑loss costs and the refund mechanism tied to a large block that the city could not replicate alone.

No formal action was taken during the presentation. Manager Daniels said the city will likely rebid the entire package next year to pursue additional savings and that staff will bring any formal recommendation back to the council when appropriate.