11-11-2026 10:10pm

Warren County Faces 55% Increase in Health Insurance Protection Costs for 2027

Beth Callahan Editor

LEBANON, OH -- Warren County officials are facing a 55% increase in the cost of insurance designed to protect the county from exceptionally large employee medical claims, adding approximately $354,000 to the county's health insurance expenses in 2027.

During this week's Warren County Commissioners meeting, Alison Ruehlmann of HUB outlined the rising costs of stop-loss coverage, which protects the county's self-funded employee health insurance program against unusually expensive medical claims.

Unlike employers that purchase traditional health insurance, Warren County operates a self-insured program, meaning the county pays employees' medical claims directly rather than paying an insurance company to assume that risk. Stop-loss insurance provides financial protection when claims become exceptionally costly.

The county's current stop-loss insurance provider, One80 Intermediaries, has proposed increasing its annual premium by approximately $354,000, bringing the total cost to nearly $1 million in 2027.

Ruehlmann explained that the county experienced an increase in large medical claims during 2026. Through October, four individuals covered by the plan had medical claims exceeding $325,000 each.

Under the current arrangement, the county is responsible for the first $325,000 in claims for each covered individual. An additional $500,000 threshold must be satisfied before reimbursements begin.

Despite the substantial increase, Ruehlmann recommended renewing with the current carrier. More than 10 competing insurance companies were contacted, but either declined to provide quotes or offered substantially higher rates.

Commissioners also discussed whether increasing the $325,000 individual threshold could reduce premiums. Although raising it to $350,000 could save approximately $100,000 in annual premiums, Ruehlmann cautioned that the county's ongoing medical claims would likely result in greater expenses than the savings.

The discussion highlighted the importance of stop-loss coverage during particularly expensive years.

In 2024, Warren County paid approximately $380,000 in stop-loss premiums but received nearly $4 million in reimbursements from its insurance carrier, demonstrating the financial protection the program can provide.

Commissioners acknowledged that increasing insurance costs are creating challenges for self-funded employers while discussing the county's efforts to manage expenses through wellness programs and other cost-control measures.

Commissioner Shannon Jones raised concerns about the long-term sustainability of stop-loss insurance as premiums continue to increase.

Ruehlmann noted that stop-loss premiums account for less than 5% of the county's overall health insurance budget, with actual medical claims representing the largest expense.

While commissioners expressed support for continuing the coverage, they also discussed the importance of reviewing insurance options annually to balance costs against the county's financial exposure.

The proposed 2027 renewal would also remove a restriction on imposing new, higher deductibles for individual high-cost claimants in future renewals, potentially creating additional financial uncertainty beyond 2027.