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SDRMA Employee Health Benefits Cost Comparison
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Requested Action(s)
recommendation
a.) Receive a follow-up update regarding employee health and ancillary benefit options available through the Special District Risk Management Authority (SDRMA) and review the associated 2026 cost comparison; and
b.) Discuss the Medical EPO, Platinum PPO, and Gold PPO plan options and provide direction to staff regarding the benefit options and employer contribution structure to further develop for future Commission consideration.
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Financial Impact:
There is no immediate fiscal impact associated with receiving the update, reviewing the cost comparison, or providing direction to staff. No enrollment or expenditure authorization is requested through this item.
The comparison is based on four currently enrolled employees and assumes that each employee’s contribution will remain fixed at the current amount of $266.97 per month. The estimated costs are:
|
Benefit Option |
Total Monthly Premium |
Monthly Employer Cost |
Annual Employer Cost |
Annual Increase |
|
Current County benefits |
$9,891.32 |
$8,823.44 |
$105,881.28 |
- |
|
SDRMA Gold PPO |
$14,221.38 |
$13,153.50 |
$157,842.00 |
$51,960.72 |
|
SDRMA Platinum PPO |
$15,191.64 |
$14,123.76 |
$169,485.12 |
$63,603.84 |
|
SDRMA Medical EPO |
$16,932.34 |
$15,864.46 |
$190,373.52 |
$84,492.24 |
|
|
|
|
|
|
Based on these assumptions, the annual employer cost would increase by approximately 49.1% under the Gold PPO option, 60.1% under the Platinum PPO option, or 79.8% under the Medical EPO option.
The SDRMA comparison includes medical coverage, the High 51+ dental plan, VSP Option 3 vision coverage, and $20,000 in basic life insurance. It does not separately identify costs for short-term disability, long-term disability, or other ancillary benefit elections. Final costs will depend upon the plans selected, employee enrollment, dependent coverage, the employer contribution structure approved by the Commission, and completion of SDRMA’s eligibility and underwriting requirements.
Background Information:
As part of the Commission’s previously authorized work to explore establishing an independent employment and benefit structure, staff have been evaluating employee health and ancillary benefit options available through SDRMA.
At its prior meeting, the Commission received an informational presentation from SDRMA regarding its Health Benefits Program. The presentation outlined available medical and ancillary benefit options, the administrative resources available through SDRMA, and the process for evaluating and pursuing participation. The Commission authorized staff to continue preparing the required underwriting materials and return with benefit options, cost estimates, contribution alternatives, implementation requirements, and necessary documents for Commission consideration.
Since that meeting, staff has continued coordinating with SDRMA and has received 2026 premium estimates for four currently enrolled employees. The estimates evaluate three medical-plan alternatives, the Medical EPO, Platinum PPO, and Gold PPO, combined with dental, vision, and basic life insurance.
For comparison purposes, the analysis maintains the current employee contribution of $266.97 per employee per month. The remaining premium is shown as the employer contribution. Under this assumption, the Gold PPO provides the lowest-cost SDRMA option, with an estimated annual employer cost of $157,842.00. The Platinum PPO option is estimated at $169,485.12 annually, while the Medical EPO option is estimated at $190,373.52 annually.
The estimates are preliminary and are intended to allow the Commission to compare the available plans, understand the potential budget impact, and provide direction regarding which options and contribution structures should be carried forward. This item does not authorize enrollment in SDRMA’s Health Benefits Program or selection of a final benefit plan.
Following Commission direction, staff will continue working with SDRMA and return with the selected options, final cost information, implementation timeline, proposed contribution structure, authorizing resolution, Memorandum of Understanding, applications, enrollment actions, and any other documents required for final Commission consideration.