Warren County's employee benefits bill could climb $3.5 million in 2027, reaching a projected $18.9 million.

Commissioners Tom Grossmann, Shannon Jones and David Young are scheduled to hear the figures Tuesday, Oct. 20, when benefits consultant Alison Ruehlmann of Hub International presents the 2027 renewal at the board's regular session, according to the meeting agenda.

The proposed budget assumes no plan changes and covers medical, dental, vision and pharmacy claims, stop-loss premiums, health savings account contributions and consulting costs. It represents a 23% increase over the county's 2026 estimated benefits budget of roughly $15.4 million.

The county is already running over budget in 2026. Spending is trending toward $17.5 million, 14% above the original estimate. At a Sept. 1 session, Fiscal Director Lisa Dickerson told commissioners that three high-cost claimants pushed 2026 health care claims about $1.5 million over budget, according to meeting minutes. Dickerson said an operational transfer of roughly $5 million was needed to cover claims and actuarial reserves required by law.

Plan changes could shift costs to workers

The presentation lays out three options to offset rising costs, all of which would change deductibles or out-of-pocket limits for employees on the county's base health plan.

Under Option 1, the county would consolidate its two current plans into a single high-deductible health plan with a $3,000 individual deductible. That would lower the deductible for the 517 employees on the base plan, which currently carries a $3,500 deductible, but raise it for buy-up plan members who pay $2,000. The county estimates the change would save $455,000.

Option 2 keeps both plans but raises the base plan's individual deductible from $3,500 to $4,000 and shifts coinsurance from 90/10 to 80/20, saving an estimated $650,000. Option 3 goes further, pushing the base deductible to $5,000 with 70/30 coinsurance, for an estimated $1.4 million in savings.

The presentation notes those savings estimates do not account for HSA contributions.

Employee premiums increase under both rate scenarios

Regardless of which option commissioners choose, employees on the buy-up plan face a 15% premium increase starting Jan. 1, 2027. A worker with single coverage would pay $130.77 per month, up $17.06. Family coverage would rise $51.17 to $392.31 per month.

Employees on the base plan currently pay nothing in premiums. That would not change under either rate scenario. The county covers 100% of base-plan premiums across all tiers, well above the 85% average among comparable Midwest public-administration employers with more than 1,000 workers, according to the presentation.

The county's overall employee cost share would drop slightly, from 6.6% to either 6.1% or 6.4%, depending on whether commissioners approve a 25% or 18% rate increase to total funding.

Recent savings efforts

The presentation credits cost-containment strategies with saving an estimated $5.4 million between January 2025 and August 2026. The largest share, $3.7 million, came from a program called the Samaritan Fund that moves eligible high-cost claimants to Medicare. A specialty pharmacy concierge program accounted for another $1.6 million.

Twenty-one plan members account for $3.7 million in claims spending through mid-2026, according to the presentation.

Commissioners must still decide on the base plan design, finalize charge-back rates and review stop-loss insurance premiums. The Oct. 20 session begins at 10 a.m. at the county administration building, 406 Justice Drive in Lebanon, and can be streamed on the county's YouTube channel.