SUBJECT
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Approve annual Stop Loss reinsurance with Aetna for the self-insured Employee Health Plan at a total annual premium of $602,756.
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DESCRIPTION
Polk County Government maintains a self-funded employee health plan covering over 8,000 participants from both the Board of County Commissioners and Constitutional offices. To protect the health fund against catastrophic medical claims, the County purchases annual "stop loss" insurance coverage. This policy reimburses the health fund for catastrophic medical claims paid over $1,000,000 for any one health plan participant.
Current Policy (Expiring 12/31/24):
• Expiring Premium: $8.11 per employee per month ($424,704 total)
Proposed Renewal (1/1/25 - 12/31/25):
• Quotes requested/received from six (6) different stop loss insurers
• Coverage: No change from expiring policy.
• Premium: $11.51 per employee per month ($602,756 total)
• Premium increase: 41.90%
The significant premium increase was anticipated by Risk Management due to a major $3M individual health claim in 2024, which resulted in a $2M reimbursement from the 2024 stop loss policy. Accordingly, the County budgeted $619,000 for this coverage, which will adequately cover the renewal premium.
RECOMMENDATION
Request Board approval for the Risk Management Director to bind coverage effective January 1, 2025, for medical stop loss reinsurance as detailed above, for an annual premium of $602,756.
FISCAL IMPACT
Funds are budgeted and available in the Employee Health Insurance Fund.
CONTACT INFORMATION
Mark Thomas, Risk Management Director
534-5265