Department
Finance
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval of 2027 premium rates for the Medical and Pharmacy, Dental and Vision Plans effective January 1, 2027, through December 31, 2027.
body
Requirement for Board Action (Cite specific Board policy, statute or code requirement)
In accordance with Board Policy, benefit plan premiums are approved prior to the beginning of each plan year
Strategic Priority Area related to this item (If yes, note strategic priority area below)
Open and Responsible Government
Commission Districts Affected
All Districts ☒
District 1 ☐
District 2 ☐
District 3 ☐
District 4 ☐
District 5 ☐
District 6 ☐
Is this a purchasing item?
No
Summary & Background (First sentence includes Agency recommendation. Provide an executive summary of the action that gives an overview of the relevant details for the item.)
Scope of Work: Fulton County currently provides a combination of self-funded and fully insured Medical & Pharmacy (Rx), Dental and Vision programs to approximately 3,900 employees, 3,500 retirees/beneficiaries, and their eligible dependents. Under a fully insured funding arrangement, the insurance carrier pays claims from its own funds and sets premium rates to support expected claim payments. While under the self-funded arrangement, the carrier administers the plan, but claims are funded by the County. The Finance Department worked with Segal Consulting to complete the 2027 health plan renewals and premium rate projections.
2027 SELF-FUNDED RATE CHANGES
The funding rates for the self-funded plans require calculation using historical claims and enrollment data, to which actuarially sound methodologies and assumptions are applied, and costs and credits associated with administration of the plan are incorporated. Segal, our benefits consultant, performed this exercise for 2027 on behalf of the County. Below are the proposed funding (premium) rate changes for 2027. These rates are set to support the expected costs generated by members enrolled in the plans.
2027 FULLY INSURED RATE CHANGES
Fully insured plans account for approximately 38% of the total medical and pharmacy costs. The following are the proposed rates for each of the fully insured plans for 2027.
2027 VS 2026 PROJECTED HEALTH PLAN COST COMPARISON
2027 Projected Health Plan Cost
The expected total cost for all health plan offerings (Medical, Rx, Dental, and Vision) for 2027 is $127.6 million as shown below. This incorporates all renewal rate changes outlined above.
Community Impact: None
Project Implications: None
Community Issues/Concerns: None
Department Recommendation: The Finance Department request approval of 2027 health premium rates and funding as presented and summarized below for fully insured and self-insured plans:
Anthem (BCBS):
• 19.1% increase to Active and Pre-65 Retiree rates (HSA, POS, and HMO plans), with POS benefit changes
• 15.0% decrease to Post-65 Retiree rates (Medicare HMO, Indemnity, and PPO Plus plans)
Kaiser:
• 9.7% increase to HMO Active and Pre-65 Retiree rates
• 0.9% increase to Post-65 Senior Advantage rates
Humana MAPD:
• 13.6% decrease to the Basic MAPD rates
• 8.8% decrease to the Enhanced (Buy-Up) MAPD rates
Aetna Dental:
• No change to the DHMO rates
• 1.0% increase for the DPPO rates
Superior Vision (through MetLife)
• 10% decrease to Vision rates
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These changes were carefully considered, weighing the financial impact to the plan as well as the financial and logistical impact to the members. Approval is needed to begin open enrollment planning including Employee Self-Service (ESS) enrollment system modifications and communications for the upcoming enrollment period scheduled from September 28th through October 9th for active employees and October 5th through October 16th for retirees. Employee and retiree information meetings will be held virtually, starting the week of September 24th.
Department Issues/Concerns: Item needs to be approved so that we may maintain timing for open enrollment which is set to start September 28th, 2026.
History of BOC Agenda Item: Has this item previously been before the BOC? Yes.
Contract & Compliance Information (Provide Contractor and Subcontractor details.)
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Exhibits Attached (Provide copies of originals, number exhibits consecutively, and label all exhibits in the upper right corner.)
Attachment I: 2027 vs 2026 Proposed Dental Premium Rates
Attachment II: 2027 vs 2026 Proposed Medical Premium Rates
Attachment III: 2027 vs 2026 Proposed Vision Premium Rates
Attachment IV: 2027 Self insured Premiums
Attachment V: 2027 Fully insured Premiums
Contact Information (Type Name, Title, Agency and Phone)
title
Ray Turner, Finance Director (404) 612-7737
Sabrinna McTier, Deputy Director (404) 612-7646
Verna Thomas, Benefits Manager (404) 612-7639
Fiscal Impact / Funding Source
Funding Line 1:
426-999-P003-1560: Group Insurance Stabilization, General Fund, Administrative