Department
Finance
Requested Action (Identify appropriate Action or Motion, purpose, cost, timeframe, etc.)
title
Request approval of 2027 premium rates for the Anthem Medical and Pharmacy 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 on a self-funded insured basis for Anthem Medical & Pharmacy (Rx) programs to approximately 2,171 employees, 1,697 retirees. Under the self-funded arrangement, the carrier (Anthem) administers the plan, but claims are funded through cost share between the County and employees. 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.
Anthem (BCBS):
• 10.0% increase to Active and Pre-65 Retiree rates (HSA, POS, and HMO plans), with NO changes to POS out of pocket maximums.
• 15.0% decrease to Post-65 Retiree rates (Medicare HMO, Indemnity, and PPO Plus plans)
2027 Projected Health Plan Cost
The expected total cost for all Anthem health plan offerings Medical and Pharmacy for 2027 is $85.4 million as shown below. A projected $12.9M would be funded by plan members while the balance would be funded by County sources.
|
|
|
2027 Plan Year |
|
Anthem Plan Types |
Emp/Ret Count |
Total Plan Cost |
County Funds |
Employee Contribution |
|
POS |
1,038 |
$31.3 M |
$26.2 M |
$5.1 M |
|
HMO |
1,277 |
$33.2 M |
$28.8 M |
$4.4 M |
|
HSA |
513 |
$10.8 M |
$9.4 M |
$1.4 M |
|
Anthem - Act/U65 |
2,828 |
$75.3 M |
$64.4 M |
$10.9 M |
|
Anthem - O65 |
985 |
$10.1 M |
$8.1 M |
$2.0 M |
|
Anthem - Total |
3,813 |
$85.4 M |
$72.5 M |
$12.9 M |
Approval is needed to begin open enrollment planning including Employee Self-Service (ESS) enrollment system modifications and communications for the upcoming enrollment period which will be rescheduled as soon as possible and communicated to employees. Employee and retiree information meetings will also be held virtually both before and during open enrollment.
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 all Anthem plans.
Department Issues/Concerns: Maintain timing for open enrollment as soon as possible.
History of BOC Agenda Item: Has this item previously been before the BOC? Yes.
Contract & Compliance Information (Provide Contractor and Subcontractor details.)
Exhibits Attached (Provide copies of originals, number exhibits consecutively, and label all exhibits in the upper right corner.)
Attachment I: 2027 Proposed Anthem Medical and Pharmacy Premium rates
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