Subject:
Title
Amendment for contract extension with United HealthCare Insurance Company for the excess loss/stop loss insurance policy.
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Recommended Action:
Recommended Action
Approval of the Amendment for contract extension with United HealthCare Insurance Company.
• This insurance coverage is utilized in the event that an individual has over $650,000.00 in health care expenses in a year.
• The agreement provides stop-loss insurance coverage to protect the self-funded health plan from catastrophic losses.
• The extended agreement term is twelve months, with a service start date of January 1, 2027, and an estimated total expenditure of $1,757,439.00, which includes funds for a 4.9% rate increase.
• The amount for the current 2026 policy increases by $20,000.00 for the last three months of the calendar year (October-December 2026) due to the actual number of plan members being above what had been estimated for several months.
• Funds for this contract are included in the Fiscal Year (FY) 2027 Adopted Budget in the Health Benefits. Sufficient funding for the Agreement is included in the FY27 Adopted Budget for the Employee Health Benefits Fund. Continued funding for the final three months of 2027 is dependent on inclusion and Board approval in the FY28 Budget.
Contract No. 25-0926-P: Increase the amount by $1,777,439.00 to a revised not-to-exceed contract amount of $3,453,866.00, effective through December 31, 2027; authorize the Chairman to sign and the Clerk of the Circuit Court to attest.
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Strategic Priorities:
Smart Service Delivery
4.2 Achieve and maintain a high level of customer satisfaction.
4.3 Improve efficiency of service delivery through technology.
4.5 Develop and retain a highly skilled and efficient workforce
Summary:
Summary
This insurance provides third-party administration services for stop-loss insurance coverage, protecting the self-funded health plan from catastrophic losses. Coverage is triggered if the individual has over $650,000 in health care expenses in a year.
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Background Information:
Gallagher Benefit Services recommends the contract renewal, which requires the carrier to be agreeable to conditions such as no new lasers at renewal, waive any active at-work provision, agree to the County’s plan document and the Summary Plan Description (SPD) that are the guiding documents for claims approval, no additional exclusions or limitations, and other additional underwriting considerations. The renewal with United HealthCare Insurance Company is based on an agreed 4.9% price increase, contractual conditions, and the current market conditions, which could have required an increase far above the 4.9%.
Fiscal Impact:
2026 Calendar Year Contract Total $ 1,676,427.00
2026 (Oct-Dec) FY27 Additional Funds for the actual number of
plan members above estimated in the contract $ 20,000.00
2027 Calendar Year Contract Total (including 4.9% rate increase) $ 1,757,439.00
Total Contract Expenditure Not to Exceed $ 3,453.866.00
Funding for the last three (3) months of the current Contract Policy October 1, 2026, to December 31, 2026), and the first nine (9) months of the renewal period (January 1, 2027, to September 30, 2027) is included in the FY27 Adopted Budget for the Employee Health Benefits Fund. Sufficient funding for the Agreement is included in the FY27 Adopted Budget for the Employee Health Benefits Fund. Continued funding for the final three (3) months of 2027 is dependent on inclusion and Board approval in the FY28 Budget.
Staff Member Responsible:
Wade Childress, Director, Human Resources Department
Merry Celeste, Purchasing Division Director, Office of Management and Budget
Chris Rose, Director, Office of Management and Budget
Partners:
N/A
Attachments:
Proposed Schedule - Excess Loss Coverage